View Single Post
Old 05-09-2006, 02:31 PM   #15 (permalink)
HeatherT
Senior Member
 
HeatherT's Avatar

Join Date: Jun 2005
Location: Orangevale, CA (Sac. County near Folsom, CA)
Age: 36
Posts: 740
Send a message via AIM to HeatherT Send a message via Yahoo to HeatherT
Default

Quote:
Originally Posted by bridgetgirl
Its not cosmetic, its reconstructive, You have the burden of proof showing how detrimental the hanging skin is too your health. Like at it this way,if a women needs a masectomy, if she wants it they will give her a breast prosthesis. This is elective, and cosmetic. But how detrimental is it to her psyche to llok at her chest post masectomy? Devistating. the same can be sad for us, and if anyone disagrees that you can prove without reasonable doubt how terrible ythe skin is, then its sheer descrimination. Rashes, poor hygeine, sores, back pain, shoulder pain, a pannus that hangs to your private areas... etc, this on top of the look og horrid hanging skin can be mentally devistating as well. Thinking, I lost 150 pounds, I have this pain, I look awful, still look fat (skin) become depressed and eat their way out of the surgery.
If you document your health detrements, they have no other choice but to approve. And if your carrier doesnt, you appeal, and appeal agin. If you have ot takeit all the way to the Supreme Court of Appeals, you do it. Otherwise its just descrimination. It has been my experience that most people either dont try, and if they do and they get denied they dont appeal. They find it easier to get a loan or take a 2nd mortgage on their home. If thats an option for you , cool. But for some it not.

Insurance carriers will pay for breast lifts, but NOT implants.

Good luck n stuff.
I have Healthnet HMO & is says it will cover reconstructive but i dont know where to begin...or if there is enough hanging...i am a little eary to be thinking this i guess becuase i hope i am not done losing but i am wondering...what insurance did you have cover the surgery? i would LOVE to have the tummy, thigh, & breasts lifted they hang & its gross! but i dont think i want arms done as i scar really bad & dont want to not wear tanks now that ifinaly feel good in them even with the little wings i do have i can live with it! but the roll around the middle BUGS me...i have only lost a total of 88 pounds since i first saw te surgeon - & really only 75 since surgery - but i will be in normal bmi in 2 pounds so i am happy with the results - i have lost 88% of the weight that they felt i could lose ( the Dr made me gain 13 pounds before she would refer me to the surgeon.... but than i lost that before surgery so really i was only 238 for less than 6 months i was 225 for a few years & the insurance said i wasnt heavy enough to have surgery....what do you think bridget what should i be doing to prepare ad get that tummy, thigh & breast lift covered? does anyone have a good letter to get the insurance to cover it???

thank you so much for the information in advance!
__________________
Heather
244... / ........ 174......../ ......153.5........ /131... / .............125 ..../.......137
pre-op /1/06@3 months/ 4/06 @ 6 months/ 10/16/07 (1year) / my goal./current 8/29/07
LAP RYN 10/18/05 Dr Sanchez in San Francisco, CA
tummy tuck, lypo(removed 300cc from each flank and 350cc from tummy & breast argmentation 450 implant filled to 600cc on 8/23/07, Dr Sumida Folsom, ca
HeatherT is offline   Reply With Quote