Anyone have experience with BCBS-MA?

[amazon 579]

I called today and found out that I would be covered for skin removal (tummy). But they have "conditions". I've had the policy emailed to me.

I'll have my bariatric group review it and go from there.

I have had rashes in the folds, but wonder if that's enough. It's been recorded at my last appointment.

I'm just curious if anyone has dealt with these folks before to know if there are major hoops to jump through - or if simple documentation is enough.

If they cover the panni removal...I could probably pay for a full Tummy Tuck. Which would be awesome.

[Stephanie Stroup McIntosh 157]

Most companies do require some proof. I spoke with a plastic surgeon last week and he said that most companies want you to be at a stable weight for at least 4 months and have "several months" of documented issues related to the excess skin. If that is the case for your insurance, you may just have to wait a few months. I would take pictures of your rashes and bring it up at every doctor's appointment. They want to make sure that you have tried other methods to heal the skin before removing it. Good luck.

[amazon 579]

Thanks :-)

I'm not personally in any hurry, but insurance wise I could be. I'm fortunate that it's covered on my husband's plan. I'm not sure how much longer we will have this coverage (his job is not terribly stable). So that's making me think about it sooner than I thought would have.

I'm not at goal yet. I would prefer to be, of course. I'm very motivated to get there!

[spiritedcowgirl63 108]

I had documented and pics of rashes. They denied prior to pics, but overturned when pics shown. They too will pay panni only. I'm paying for the TT upfront and I'm to be reimbursed after. Makes me think if anyone has had an issue with ins paying for the panni after the patient upgrade.

[amazon 579]

It makes me wonder what they consider necessary. I mean, I get rashes. Some times, to me, they are "bad". Other times more like bright red inflamed, itchy, and - sorry - stinky red lines in the fold(s) that will get bad if I don't keep ahead of it. That will happen from just an afternoon of being outside on a nice day doing stuff. I hate it.

I'm clean, shower, etc. lol. Not trying to scare anyone

Do I need to let it get really bad? Infections? I don't want to...

Does the doc have to take the pics? Can I document things?