Insurance Companies DO cover plastics

[LoquaciousLaura 6]

On a daily basis I wear 3 major things under my regular clothes.

First I put on a back smoother bra the one I love is Lane Bryant's they are buy 2 get 2 free right now...hop on that deal!!!

http://www.lanebryan...36851/index.pro

2nd I wear Spanx Slimplicity Open-Bust Mid-Thigh Bodysuit

http://www.spanx.com...rentPage=family

This is so worth the price but hand wash them and they will last you

only draw back is having to take shirts off in order to poo but these have a gusset and you can tinkle in them and no you don't really pee on them but it is something you have to get use to it's kinda yuck at first but now I love the gusset.

3rd I wear Spanx

On Top and In Control Essential 3/4 Sleeve Bateau

http://www.spanx.com...rentPage=family

These give the look of having slender arms. Even in 103 degree weather I wear them and let me tell you, you sweat in these the same as if you did not have them on. The only difference is that they absorb the sweat rather than having your clothes get wet with sweat. LOVE LOVE LOVE these attached is a photo of me without them and with them, you'll be sold on these too

Here i'm wearing it with a sleeveless halter dress

here i'm wearing the spanx on top and in control 3/4 sleeve by itself with a skirt and a belt, looks like a dress right?

hope this all helps!!

Lots of insurance companies do cover plastics after weight loss surgery. They must be medically necessary so have your pcp write a referral to a surgeon, Have your pcp document any issues related to the loose skin...rashes (keep receipts for creams too) or neck and back pain, etc. photos of the rashes are very helpful in getting approvals. Do not refer to it as plastics or cosmetic surgery, it is body contouring after massive weight loss.

I went to a plastic surgeon Thursday and now waiting for pre-authorization from my insurance co for plastics. Passing along the cpt codes... you can call your ins co and ask if the codes are covered...if you ask about the procedures the operators always say no cause they don't know any better. Mastoplexy (breast lift) "cpt code 19316", Brachioplasty (arm lift) "cpt code 15836", Thigh lift "cpt code 15823", panniculectomy (tummy tuck w/no muscle reconstruction) "cpt code 15830".

Again don't call there and ask "is plastic surgery covered" the operators are not the ones who know...they simply are call center operators that can relay info from your file or their computer and can change pcp, address, etc info in your account. They are not experts they use a intranet to search for the answers to your questions. A middle man so to speak. They do not make the decisions they can pretty much only change your pcp or give you info based on what is in your file. Pretty much all you do is call get a rep and say "i am interested in finding out if some procedures are covered, i have the CPT codes" They will be more than happy to give you the answers because you have done half the work by having the CPT codes ready for them. Let me know how it goes. Be sure to ask the % covered some are 80/20 mine is 100% with a $250 co pay after my high deductible is met which it is my daughters are having their tonsils removed this year.

I am pursuing brachioplasty and mastoplexy and my surgeon is going to zig zag the scar in my armpit so he can pull the bra back skin into it and make it one long scar from my inner elbow into my armpit and down under my breast and up to center so it's back breast and arm all at one time. One procedure one long scar on either side which i am fine with. better than 3 different procedures.

[LESLIEH 68]

Thanks for the info. I've started the process with documenting my "rashes" and how my back pain has returned. My PCP is stubborn so I might have to have my surgeon and pain management Dr write something stating the skin removal is necessary.

[former_vbg 198]

Thank you for sharing those CPT codes. You are quite right about the reps just basically reading from scripts or what they can dig up on their intranet. I so very far away from this point, but I have saved those CPT codes and will be calling next week just out of curiosity.

Thanks again for sharing!

[ldydrgnkpr 49]

Yes thank you for sharing. I just looked at what UHC states in the "Procedures Covered" It states that "Reconstructive" surgery is covered.

I will be seeing my PCP on 7/15 and will start documenting that the excess skin is causing pulling and how painful it is. Below is what my policy states. I will be calling with some CPT codes to get clarification. I have found that 2 plastic surgeons in my area are on my "In Network" list. If anyone has UHC and has any addtional info please do share. If I find anything out I will share as well.

Deb

Reconstructive Procedures

Same as

● Physician's Office Services

● Professional Fees

● Hospital-Inpatient Stay

● Outpatient Diagnostic and Therapeutic Services

● Prosthetic Devices

You can contact Care Coordination at the telephone number on your ID card for more information about Benefits for mastectomy related services.

The following services are not covered:

● Cosmetic Procedures. Examples include:

● Pharmacological regimens, nutritional procedures or treatments.

● Scar or tattoo removal or revision procedures (such as salabrasion, chemosurgery and other skin abrasion procedures).

● Skin abrasion procedures performed as a treatment for acne.

● Replacement of an existing breast implant if the earlier breast implant was performed as a Cosmetic Procedure. NOTE: Replacement of an existing breast implant is considered reconstructive if the initial breast implant followed mastectomy.

● Physical conditioning programs such as athletic training, bodybuilding, exercise, fitness, flexibility, and diversion or general motivation.

● Weight loss programs whether or not they are under medical supervision. Weight loss programs for medical reasons are also excluded.

● Wigs regardless of the reason for the hair loss.

[losetobemeagain 9]

Thanks for the info. I've started the process with documenting my "rashes" and how my back pain has returned. My PCP is stubborn so I might have to have my surgeon and pain management Dr write something stating the skin removal is necessary.

My PCP is a pain in the butt about anything to do with weight loss, and I was wondering if the insurance co. would accept something from my surgeon? how did it go for you? I also have a hernia right above my belly buttom someone said you can get approved easier with that? does anyone know if that is true?

[former_vbg 198]

I can't speak from personal experience since I am still on my weight loss journey, but I know others who have worked directly w/their surgeon's office submitting to their ins. company. The only draw back is multiple visits to establish that "history" most ins. companies want that you have tried other things to resolve the rash issues. You might also try working with a Dermatologist, but if you are required to be referred in your ins. plan that could present a challenge.

If you can, try to find the surgeon you want to do your plastics, make an appt w/him or her and talk with them about it. I'm sure they could also guide you on this.

My PCP is a pain in the butt about anything to do with weight loss, and I was wondering if the insurance co. would accept something from my surgeon? how did it go for you? I also have a hernia right above my belly buttom someone said you can get approved easier with that? does anyone know if that is true?

[losetobemeagain 9]

I can't speak from personal experience since I am still on my weight loss journey, but I know others who have worked directly w/their surgeon's office submitting to their ins. company. The only draw back is multiple visits to establish that "history" most ins. companies want that you have tried other things to resolve the rash issues. You might also try working with a Dermatologist, but if you are required to be referred in your ins. plan that could present a challenge.

If you can, try to find the surgeon you want to do your plastics, make an appt w/him or her and talk with them about it. I'm sure they could also guide you on this.

Thank you...

[Lessizmoore 0]

Thanks for the great info. You look wonderful! Love that hat!

[jacob bensen 1]

You looks great in the dress. Have you done with the surgery? If yes then what was the result.

[former_vbg 198]

How did your surgery turn out? Just curious if you have anything you would do differently?

[JanieL 6]

I am so glad to hear I might be able to get some help with all the extra skin I have. Thanks for all this great info. I am going to see a plastic surgeon next week to see about breast reconstruction because of a lumpectomy I had because of recent breast Cancer. The nurse said the breast had to be bad enough for the insurance to consider implants. I am so saggy losing all my weight then on top of that having a chunk taken out because of the lumpectomy. i sure hope he helps me get this fixed. Maybe even help me get oked to do a Tummy Tuck. Here's hoping!

[Kiki Von Moonshine 53]

I too would like to know how the suegery went OP.

[cmw10000 35]

My Name is Cindy and am 6 weeks post surgury. I would like to know how this turns out with the ins co.