Sunshine3073 22 Posted August 25, 2015 1. Did your insurance pay for plastic surgery after your weight loss? 2. What hoops did you have to jump through, if any to get your insurance to cover your plastic surgery? 3. What type of plastic surgery did your insurance cover? Any other information would be great. I need to find out if my insurance will cover and need to know the right questions to ask and how to word my questions. TIA. Share this post Link to post Share on other sites
ProudGrammy 8,322 Posted August 25, 2015 insurance pay for plastic surgery after weight loss? @@Sunshine3073 NO i had a facelift 2 months ago asked/confirmed that plastics for face lift is not covered by insurance i didn't think they would primary insurance is Medicare - i knew they wouldn't cover after mush "discusssion" my secondary insurance did pick up the hospital charges, room/ meds etc I don't think plastics are usually covered take pictures while you are loosing weight with ex. the apron if many blisters, other problems occur from the loss of weight, MAYBE they will cover - not sure good luck kathy Share this post Link to post Share on other sites
hollyr 49 Posted August 26, 2015 1. Did your insurance pay for plastic surgery after your weight loss? 2. What hoops did you have to jump through, if any to get your insurance to cover your plastic surgery? 3. What type of plastic surgery did your insurance cover? Any other information would be great. I need to find out if my insurance will cover and need to know the right questions to ask and how to word my questions. TIA. Hi! I had a lower body lift 6 weeks ago (on Thursday is 6 weeks). I have UHC and am from Texas. My insurance would not cover anything. Regardless of history of rash etc. So I paid out of pocket. You may want to check on any FMLA/ short term disability. I looked into my plan a few months before my surgery. I was told verbally that this procedure would be cause for me to get the actual disability money and FMLA. So I planned accordingly and even cashed in PTO to help pay. My dr submitted the forms as requested the Monday before my surgery that was on Thursday. On Wednesday I received a call from my disability company stating my procedure was not covered. I had already paid my procedure in full with no refunds. I was so upset. Luckily I had a month of PTO still to use. But they also denied the part that protects my job. So frustrating. I have a great boss and now started working again from home. Even this far out there are so many physical things I cannot do myself. Good luck! Hopefully your procedure will be covered. Holly Share this post Link to post Share on other sites
jess9395 5,449 Posted August 29, 2015 My insurance didn't pay any of mine though we tried to submit. My insurance will pay for plastics for panniculectomy and brachioplasty but has VERY specific requirements including specific measurements like how far the Pannis hangs and it has to be past the pubic bone. With their requirements I could have documented millions of rashes and functional issues and still not been approved bc the measurements just weren't there Share this post Link to post Share on other sites
Spiceyfrog 269 Posted January 8, 2016 @@Sunshine3073, I had a breast lift/augmentation and brachioplasty a week and a half ago and my insurance company (BCBS) paid the hospitalization/anesthesia portion, which amounted to around $6,000. During one of my preop visits the nurse asked if I had ever considered a Tummy Tuck and I said yes, but I don't know if I will be able to get it covered because I don't have a ton of hanging skin and these two procedures were more important to me right now. She said, if I were to come back when I am 18 months postop (insurance requirement), it would be covered, she said she has been billing for over 15 years and they have never asked for pictures. Share this post Link to post Share on other sites
BethinPA 305 Posted January 9, 2016 I had a lower body lift and abdominoplasty, and that was all out of pocket. I am getting a breast lift on 1/22, and insurance is covering it. I got my GYN to write a letter, submitted my most recent mammogram, and I was approved! I was shocked! ???? Share this post Link to post Share on other sites
CowgirlJane 14,260 Posted January 25, 2016 I did not have a medical necessity so I was cash pay too. Share this post Link to post Share on other sites
JeanWilhite 0 Posted February 8, 2016 I too am curious about these questions. As far as I know, insurance does not cover most things related to plastic surgery, unless it's corrective surgery from an accident, surgery malpractice, birth defects, or etc. I think plastic surgery is regarded as means to beautify or enhance something, and not regarded as necessary, maybe this is the reason a lot of things aren't covered by most insurance companies? Regardless of your history, health, etc. Even an over abundant amount of rashes and functional issues still don't help, I heard this from many people. This is as much as I know, I may be wrong though. I've heard from other people, even people commenting on this page, saying that they were able to get insurance coverage, so I'm curious to how, and would love to get more information as well. My best friend lived in Ohio and was to undergo surgery in New Jersey. We consulted a surgeon for her operation in New Jersey before going through with the operation and also checked with physician staffing Ohio. The surgeon explained that the insurance details should be clarified in advance and hinted a few times that the process would not be an easy one and often insurance companies don't get involved with plastic-related. We found out that the insurance coverage is typically the same from state to state. Share this post Link to post Share on other sites
JamieLogical 8,713 Posted February 8, 2016 My insurance policy specifically states that it won't pay for skin removal surgery after WLS. Here's the line from my policy: "An expected outcome of successful bariatric surgery is redundant/excessive skin. Surgery to remove this skin is generally not considered medically necessary and therefore not covered." Share this post Link to post Share on other sites
BethinPA 305 Posted February 9, 2016 My plastic surgeon said that insurance almost never pays for things like a lower body lift/abdomoplasty, and I paid for that out of pocket. He said they were much more accommodating for breast issues, and encouraged me to try to get it covered. I'm thrilled that he was right, and I was covered. My GYN who wrote the supporting letter included that I had been treated for fungal infections, had back discomfort and that my bra straps cut into my shoulders. That apparently met the criteria. When I went back for my first follow up appointment, he told me, good news - the breast tissue sent for biopsy was negative for breast cancer, which hadn't even occurred to me to consider! He said a few times a year the biopsies will be positive, and he has to break the bad news. So sometimes a breast reduction can save a life! Share this post Link to post Share on other sites
spiritedcowgirl63 108 Posted February 12, 2016 I documented rashes and got rx creams dr visits etc for 18 months. Insurance paid panini removal only. I paid for the upgrade to full Tummy Tuck. Love the results but the bill after was not what was written and I ended up paying $7k over the insurance payment. Didn't realize this til after surgery. Share this post Link to post Share on other sites
JamieLogical 8,713 Posted February 12, 2016 I documented rashes and got rx creams dr visits etc for 18 months. Insurance paid panini removal only. I paid for the upgrade to full Tummy Tuck. Love the results but the bill after was not what was written and I ended up paying $7k over the insurance payment. Didn't realize this til after surgery. I paid less than $7 for my extended tummy tuck with the whole thing out of pocket... Sounds like you jumped through a lot of hoops for your insurance and it didn't really do you much good. Sorry to hear that. But it's awesome that you are happy with your results! Share this post Link to post Share on other sites
spiritedcowgirl63 108 Posted February 13, 2016 I'm thinking of going to mx for arm surgery. Your thoughts? Share this post Link to post Share on other sites
JamieLogical 8,713 Posted February 13, 2016 I'm thinking of going to mx for arm surgery. Your thoughts? There are many fantastic surgeons in Mexico. So just do your research. Fortunately, arm lift doesn't require as much local recovery time, so you should only have to stay a few days. Share this post Link to post Share on other sites