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Old 03-14-2013, 07:35 AM   #31
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Originally Posted by Trillex View Post
This is probably an extremely ignorant question, but does insurance not cover skin removal surgery when people have lost so much weight that the skin becomes a health and hygiene issue? If you have medical insurance, like through your employer or Blue Cross or whatever, wouldn't this qualify as a legitimate medical need? Especially for people who have had weight loss surgery.
I couldn't quickly find the thread, but I know some posters have had trouble getting coverage even when they could show a history of infections and other problems with the hanging skin. (What really stuck with me was that the insurance company wouldn't pay for creating a belly button afterwards, since that's cosmetic.)
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Old 03-14-2013, 12:58 PM   #32
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My doctor helped me back when I was losing the weight by recording in her chart every skin irritation I had. I got lucky that the infected cyst happened because I happen to have an insurance plan that covered the diagnostic code for the panniculectomy, otherwise I wouldn't have been able to get it done. I would have only had the cyst removed.

Today's appt went well. I was told I am a good candidate. I have no health issues and am happy with my current weight. If I lost no more weight, that would be fine with me. He asked me to list what bothered me the most in order. I told him my neck and lower face where the jowls are, then the breast/arms. Then thighs. We talked about the eyes but they won't do them at the same time as the face/neck lift. Because I contacted this team through the "clinic", it is used as part of the training program at Mass General in Boston, Mass. The same Board Certified surgeons oversee and attend the Chief Resident who will do the surgery, but I get a discount on the price of the surgery. The neck/face lift including the overnight at the hospital and anesthesia is around 6300. The breast lift & arm reduction will be about $6800 and the thigh lift about $5500. If you have two surgeries at the same time, the second procedure is half price. That is why the breast&arms is not to much more than the others. If I were to have my eyes done when they do the thighs, for example, it would be $2000 more. If done by itself, it would be $4000. I know that going through the main door to the plastic surgeon would be a lot more, so if you live near a big city, check to see if their teaching hospital that has a "clinic". You must call them first for the evaluation to be part of it.

The next step is to go back on Mar 29th for a 15 min appt with the surgeon to give him my official decision, then schedule the surgery. I think the surgery will happen in April. The drains come out within 1-2 weeks, the majority of the scars will be gone within 4-6 weeks. I figure I can get my roots done just before the surgery, then I ought to be good to go for 5 weeks. I will probaby miss 3-4 weeks of work and when I am ready to go back will work from home for the next 2 weeks. I will then need to wait awhile for the next one, probably Aug or Sept.

Even though it is elective, I figure having a baby is elective and is covered. The insurance does not pay for the surgery but my short term disability will cover my pay for 30 days. My daughter lives in Hyannis on Cape Cod so she is going to pick me up and I can recuperate at her house. The good ocean air should help with the healing. Hope the Power is with me through this whole exciting adventure. It is my 65th birthday gift to myself.
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Old 03-14-2013, 05:15 PM   #33
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Originally Posted by biancasteeplechase View Post
I couldn't quickly find the thread, but I know some posters have had trouble getting coverage even when they could show a history of infections and other problems with the hanging skin. (What really stuck with me was that the insurance company wouldn't pay for creating a belly button afterwards, since that's cosmetic.)
This is just fascinating to me! Bellybutton?! That is quite cruel, I think. I can't imagine that small, cruel insurance rule actually saves the plan provider much money.

I've actually been looking up medical insurance laws since reading this thread. And it seems sort of like the Wild West -- provisions and regulations vary from state to state and the contracts are individualized without, it seems to me, consistent standards for providing premium payers with any sort of equitable guarantees of coverage. I honestly don't understand why an industry that, literally, deals with life and death issues is regulated in such a random way.
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Old 03-14-2013, 05:42 PM   #34
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The thread is the Excess Skin Removal thread and it is full of people (including me) who have had procedures done and write about their experiences. I think it may be under the Weight Loss Surgery area of the boards.

Congrats, Mary! Plastic surgery can be life-changing!
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