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paintlady1954

I need plastic surgery BAD

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I am a gastric bypass patient of almost 10 years. I have a huge fold of skin hanging from my stomach area & my arms look as though I have 4 arms

from the hanging. I cant stand to look at myself in a mirror ,I dropped 200 pounds & have kept it off.

My insurance will not pay for the surgery to rid me of all this hanging skin & I cant afford it on my own, HELP !!!

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I am a gastric bypass patient of almost 10 years. I have a huge fold of skin hanging from my stomach area & my arms look as though I have 4 arms

from the hanging. I cant stand to look at myself in a mirror ,I dropped 200 pounds & have kept it off.

My insurance will not pay for the surgery to rid me of all this hanging skin & I cant afford it on my own, HELP !!!

Dear Paintlady1954,

Congratulations on your weight loss achievement.

Have you already tried to submit to your insurance and received a denial?

Have you appealed the decision?

I have seen many denials overturned after an appeal.

It usually helps if your plastic surgeon speaks with the insurance company medical director directly to explain the medical necessity.

It may help cover the cost of the abdominal surgery but insurance is unlikely to cover the arm surgery.

Let me know if I can help.

Sincerely,

Abhay Gupta, MD.

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do you know if tx medicaid/medicare cover any plastics?

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do you know if tx medicaid/medicare cover any plastics?

Hello Marcus

In my experience, insurance companies (including Medicare and Medicaid) do sometimes cover the cost of plastic surgery reconstruction after weight loss, but usually only the abdomen.

I have very rarely seen an insurance company cover the arms, thighs, or breasts.

To have the best chance of coverage, you should document chronic rashes underneath the skin pannus (skin apron) and history of ulceration and infection.

The other thing that is helpful to document is a history of lower back pain due to the excess weight of the extra skin apron.

If you have a hernia in the abdomen after your bariatric surgery, insurance will usually cover repairing that, and the plastic surgeon can sometimes get the skin excision covered at the same time.

When you see your plastic surgeon in consultation, ask them if they would help you in applying for insurance coverage of the reconstructive procedures. Hope that helps, and good luck with your surgery.

Sincerely, Abhay Gupta, MD, FACS.

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