Insurance approved Plastics

For those of you that have had this done. What was the process you used to get some type of plastics...ie...breastlift, panni, etc? What were the codes used for insurance approval? I know that I should at least try it but I would like to be a little exact for the codes and how to word it. My boobs are straight flat and threw....and I know a panni should help with the other stuff. My tail bone hurts like crazy but I guess that's because there isn't anything back there to cushion it.

I have read somewhere that a person that has had massive weight loss surgery has been approved for a panni because she was experiencing back pain issues. My back pains are worse and more frequent now than when I was bigger!!

Any help is greatly appreciated!!

Panni surgery just removes excess skin, nothing pretty like real plastic surgery. No tightening of stomach muscles either.  You'll need to see you doctor to document skin rashes, fungal issues, the inability to exercise or walk well due to excess skin, etc.  Photos help too.  You need to be 18 months post op and/or at a stable wt for at least 6 months as a general recommendation.  Your PCP should be able to help you, as you'll likely need a referral from that doc.  Breast reductions may be authorized, under specific conditions.  Tailbone pain is pretty normal.  You really need to discuss this with your PCP and follow their guidelines.  Real plastic surgery is usually only paid for by insurance for cancer or burn victims. Otherwise it's considered cosmetic, and normally not covered.  One local plastic surgeon works with KaiserDAVE to reduce the bill for a "real deal" tummy tuck.  He's able to deduct the cost of the panni surgery from his services, reducing your cost by around $3k. 

In California the DMHC says your ins legally has to cover reconstructive surgery. Diana Cox is the one you would want to direct your questions to. Who is your provider ?

Anthem Blue Cross HMO

You qualify, and Diana has all the free copies of her appeal that she loves to help people with.

Thanks!! My PCP has already put in the referral and I am now waiting the 5 working days. I will try to find her to see what it is that I need to have noted for the insurance but I am going to keep looking and researching.

I have Anthem Blue Cross and was told in my pre op classes that at least, the panni removal would be covered without question and most of the time the damage caused to the muscles from being obese are covered too. 

Does anyone know if Cigna covers plastics? I'm thinking of the panni but for sure my arms... I get a lot of rashes..

 

Helen 

In my opinion, I think all insurance companies should pay for plastic surgery after major weightloss as much as people pay into them every month. I think anything you need should be covered. Just had to get that off my chest cause it shouldn't be that hard. We all want to look normal without all the hanging skin, geesh. If only it was that easy.