Ruby-red

Reconstructive surgery after weight loss

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Hi, friends!  I am looking to start a conversation about reconstructive surgery after weight loss.  Has anyone had a lower body lift?  Has anyone used insurance to help with a portion of the cost? Thanks in advance for your time.  

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The insurance company paying out for these things are so rare I just jumped to thr next step and paid 24,000. Out of pocket. Just had surgery last Friday Sept 30th 

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I have been doing research and really depends on your insurance coverage. I have noticed that that most policies that cover reconstructive surgery have a common factor which is documents that you have rash under the stomach. 

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hi amber where did you have surgery at ? What did you have done ? 

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It does depend on your coverage. For me, the only surgery the insurance will cover is the panniculectomy, which is the removal of the flap on your stomach. No lifts (upper, lower, or partial), breast recontouring, upper arm flap....nothing. All of it is considered cosmetic with my plan. But, the doctor I saw when I went in for my consult said that because the insurance does cover the panni, then make sure I get it done along with something else because it will include the hospital costs, pre and post op follow ups, blood work...anything associated with getting the procedure done. The only thing the insurance won't cover is the cost of the actual procedure outside of the panni.

Also, they did mention, as someone already has on your thread, that if you have a documented necessity for the surgery (rashes with documented treatment, severe pain associated with the excess skin, necrosis, etc), then you might be able to get it partially, if not fully, covered. But, they are very, very picky.

Interesting example on how finicky insurance companies can be: my friend originally went in for a consult on a breast reduction because she was having chronic pain in her back, sides, and neck because of the weight of her breasts (she was something like a 44 I) and they told her she had to lose weight before she would be approved for a breast reduction, so she had the gastric bypass (she was at about 325 lbs and a 45+ BMI, I don't remember exactly what her BMI was pre-op). She lost most of her weight with the surgery and when she went back in for the follow up consult after she lost more than what they requested her to lose, they then told her that she didn't qualify for it to be covered because it was now considered cosmetic. She appealed the decision, but I don't think she ever got it done or followed up because who knows. It was a pain, though, and incredibly frustrating.

I would probably play it safe and anticipate having to pay for most, if not all, of it out of pocket. That way, if insurance covers some of it, it's good news. Better than expecting insurance to pay for it, then being told no later on.

Right now, I'm putting money away every month to save up for the surgery. I'm going to go for a lower body lift, which I have to save about $9,000 to cover it (at least that was the quote a year ago). I also want to have my bat wings taken care of and that will likely be about another $4,500 or so. Breast reduction will be about $6,000. I've got time.

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Good morning Zen-Steph, I think that's probably the best way to go. Expect the worst case scenario and hope for the best.

 

 I had my arms done out four years ago. And I wasn't happy with the results. I now know that choosing a doctor hwho specializes in post weight loss patients is very important. 

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On 10/9/2016 at 5:09 AM, Ruby-red said:

hi amber where did you have surgery at ? What did you have done ? 

Sorry I never got this notification! Dr Sheldon cober. I'm in Oregon he is in Tanasbourne area. I had breast lift with implants, brachioplasty and inter thigh lift. Part 2 in about 5 months is a post body lift (the outer thighs butt and low back) 

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Congratulations!  Are you happy with your results? I'm still on the fence about having surgery. Even though I know I'll have to eliminate all my issues. 

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25 minutes ago, Ruby-red said:

Congratulations!  Are you happy with your results? I'm still on the fence about having surgery. Even though I know I'll have to eliminate all my issues. 

Beyond happy..... it's like I'm a completely different person. I can't explain it. It's not in a vain way or look at me! It's feeling what closest to" normal " I've ever felt.... check out my post under plastic surgery  (well I did it.......) if you'd like :wub:

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my insurance will cover reconstructive surgery even with  no medical issue BUTCHA they only will cover $25,000 for life so the actually bypass and for reconstructive so there's no money left after I have the surgery anyway... ive heard from alot of people tho even if ur insurance doesn't and it's causing medical issues or hygiene issues they will

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3 hours ago, Jordy03 said:

my insurance will cover reconstructive surgery even with  no medical issue BUTCHA they only will cover $25,000 for life so the actually bypass and for reconstructive so there's no money left after I have the surgery anyway... ive heard from alot of people tho even if ur insurance doesn't and it's causing medical issues or hygiene issues they will

My insurance changes from time to time, and all plans are different.

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