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Insurance coverage for breast lift in severe case?



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I have lost 200 pounds with the lap band, 34 more to go to get to my current goal weight. I am starting to look into plastic surgery options. I had a panniculectomy after I lost 80 pounds because I had such a severe pannus. This helped quite a lot as I had constant rashes and exercise was difficult. I am pretty sure that I will need a full lower-body lift with a T-incision, probably a inner-thigh lift, maybe brachioplasty although I can probably live with my arms.

But probably the procedure I need more than anything is a breast lift. My boobs are in very sorry shape, ladies. They were pretty saggy when I was at 433 pounds, and now that I have lost weight I have gone from a G or H cup to barely a D, sometimes a C cup. And they hang down almost to my waist. My nipples point straight down. It is not a pretty sight! And a lot of that C/D cup is skin. I literally have skin on skin inside my bra, as I practically fold my boobs into my bra.

So I am trying to figure out if there is any chance of getting insurance to cover a breast lift. I might also want implants, which I figure there is no chance of insurance covering, but I wonder if I can make any argument that this is reconstructive surgery rather than cosmetic surgery? I have Anthem Blue Cross PPO for insurance. Any insight or advice would be most appreciated.

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I'm going to provide a partial answer to my own question. I found this link Post Weight Loss Surgery in Sacramento: Fees, financing & Insurance which says:

"Some insurance companies will cover breast reduction surgery for women if the nipple sags at or below the bend in the elbow"

Ding ding ding! We have a possible winner here! It doesn't say whether the criteria is the inner bend or the outer bend in the elbow, but in my case, my nipples hang at least a full inch below the bottom of my elbow when I bend my arms up. If I put on my pants before my bra I sometimes get my nipples caught inside my waistband, no kidding!

Anyway, I have a consultation with my plastic surgeon scheduled for next week, but I wanted to see if any of you ladies had any information.

Kathy

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