How soon should I start documenting to try to get insurance to cover PS?

[BigHappy 16]

So I'm only 6 months in but 123 lbs down and I can tell I'm going to need surgery on my stomach area, and possibly legs. What can I do now to get the best shot at insurance covering it? My doctor hinted that I should keep telling him I have rashes in any area I want work on and he'll document it. For people who got the surgery what do they look for when you got yours covered so I can make sure I hit all the right check boxes to give me the best chance. Do they actually send photos to the insurance company or is it just on what the doc has down?

[Jerzygurl 372]

My PCP has already started documenting my rashes and issues underneath my breast and on the top part of my stomach so that I can get a breast lift and reduction and have the insurance company pay for it.

I haven't had surgery yet, but he said to start now because more than likely my breast will sag even more after the surgery and are sure to cause more rashes and issues, especially with my hot flashes. I was told it's the best way to get them to pay for it by my HR coordinator. Our insurance is pretty liberal, I just need documentation from a doctor. But I've taken pictures too. Every time I get a flare up, I've taken some pics myself. Just in case.

So, I'd say start now. keep receipts of any over the counter products you have to buy that would apply to skin issues. If your doc subscribes any meds keep track of that too.

Good luck and great job on the Weight Loss!

[Lizadaze 9]

Thanks for this advice! I'm pre-surgery but already deal with skin rashes. Just went through a horrible ordeal with an infection. I haven't taken pictures but will start documenting. My doc did prescribe meds now twice, so that is also on record.

[kidrn72 85]

My primary doc did this and I did get rashes and skin adhesions due to excessive skin under my breast. But my insurance which is Cigna refused to cover a breast lift/ reduction because it was considered cosmetics . I tried appealing it but was told my condition was not a life threatening condition and was not a covered procedure. So I said out of pocket for my breast surgery. Good luck getting insurance to cover.

[natalie_christin 61]

My primary doc did this and I did get rashes and skin adhesions due to excessive skin under my breast. But my insurance which is Cigna refused to cover a breast lift/ reduction because it was considered cosmetics . I tried appealing it but was told my condition was not a life threatening condition and was not a covered procedure. So I said out of pocket for my breast surgery. Good luck getting insurance to cover.

Then best way to get insurance to cover breast reductions are when it comes to back pain – there has to be other mitigating circumstances… My pants needs a breast reduction for her back and the insurance said it would cover it but the back pain/ damage it has to be documented...