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11.5 years ago I gave birth to a 10 pound 11 oz. baby via c-section.  I only gained 32 pounds during the pregnancy and then gained another 45 in the following years.  Because I wasn't morbidly obese when I was pregnant my OB did a horizontal, bikini line incision.  Since then I have had issues with moisture and very mild rashes on  and around the scar due to sagging skin over the scar.  My goal is to lose 100 pounds after WLS.  I know because I was already extremely stretched out from that pregnancy and now from being 100 pounds overweight I am going to have some considerable sagging when I hit my goal weight.  With all these factors, what are the odds that my insurance will consider a tummy tuck a medical necessity?  I know that the WLS isn't about looking good, it's about being healthy and getting my life back, but I would be lying if I say I don't want the opportunity to look like my former hot self.  And, having a bunch of ugly baggy skin isn't going to be too sexy. :(

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Hello CarrieT,

Thanks for your question.

After doing several hundred of these procedures and dealing with almost as many different insurance companies, I have learned that whether or not an insurance company covers a particular weight loss reconstruction procedure is highly variable and unpredictable.

My recommendation is to seek consultation with an experienced board certified plastic surgeon to discuss your options.

The surgeon can then submit your case to your insurance company for consideration and hopefully they will find the procedure medically necessary.

Good luck!

Sincerely,

Abhay Gupta, MD.

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Carrie,

 

During the consult with my surgeon for my gastric bypass, I asked about my sagging tummy as I too have had c-sections as well as 2 other abdominal surgeries.  Her question in response to mine was very poignant..."Even if you can't get that tummy tuck will that really affect whether you opt for this WLS?"  My answer was no, of course not.  As you said in your post, the ultimate goal is to be healthy and fit.  I am with you in that I would LOVE to have my high school skinny body back.  I too will be seeking out a consultation with a surgeon to see if I can get my insurance to cover my tummy tuck but if they don't well then at least I am healthy and sporting some well earned  "battle scars" from my journey in life.  Good luck on your surgery!

VH

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I just had my consult with the plastics surgeon yesterday. I have Cigna and they are impossible about anything to do with bariatric surgery and any other post op surgeries. So I have gone the path of self pay. Yes, it is expensive, but some doctors allow payment options that will make it easier. Also I am getting prices for a couple of different surgeries, tummy tuck, thigh lift and breast augmentation so I can prioritize what needs to be done and budget my costs.

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