TheRealMeIsHere!

Your age and beginning stats are identical to mine. How did you get the insurance to pay? I went to a consult today and the surgeon was 99% saying they wouldn't pay. Even with lots of documented rashes with my primary dr. Any thoughts?

I have severe ankylosing spondylosis in my entire spine, so I started with pain management. I went on my insurance website, and searched 'criteria for panniculectomy'. Took that to pain management doctor who wrote a letter of medical necessity that echoed all the criteria needed. I also wrote a letter that spoke about the co-morbidities that were resolved with weight loss (HBP, SEVERE apnea) and how exercise is crucial in keeping weight off. Also how the extra skin, was limiting my range of motion and exercise options. This along with the plastic surgeon's pictures and prior approval request went to my insurance company. And the stars and planets aligned, lol, it ended up on the right person's desk and not only was panni approved, but also abdominoplasty!! I was SHOCKED and showed the approval letter to several people who were just as surprised, including the plastic surgeon.

All insurance is different, though. The surgeon said that one insurance company required that the patient have rashes and infections so severe that they needed to be hospitalized and on IV antibiotics!