Hernias and tummy tucks - Not Needed

December 11, 2002

My insurance company approved my tummy tuck and breast lift before I

even got home from the plastic surgeon's office half an hour from my

house. I came home and there were two messages, one from the doctor's

office advising of the approval and the second from the insurance

company letting me know they approved. Blew me out of the water.

Apparently, where obesity patient's are concerned, insurance companies

are starting to consider the plastics reconstructive and not cosmetic

and covering them. At least that's what my insurance carrier told me.

I still haven't don'e the breast lift. Right now I'm all surgeried out

and feel that I'm no worse off than my 40 year old friends, except I

have the flat tummy right now. Decided if the incisional hernia gets

bigger and needs to be repaired, then I will have the boobs done,

otherwise, investing in good bras works for me. : )

Regina

December 12, 2002

I wish this had been my experience. While my insurance covered by RNY with

no problem, they absolutely denied all my appeals for reconstruction

(abdominoplasty) afterwards, in spite of the fact that I had pain from the

hanging skin. No how, no way. I didn't even attempt to get breasts

done...figured if they would do the tummy, I could do the rest. No go. No

way. No how. All the letters from all my doctors proving medical necessity

were of no matter....

and now I'm self-employed and have NO insurance. It will be a long long time

before I can afford to do any of this myself. Two weeks ago my husband cut

thru his index finger nail and required a trip to the emergency room for

stitches (Saturday afternoon, so no doctors office open, and even minor

emergency center was closed). We just got the bill....$931!! They told us

that anything that required stitches was considered " level 3 trauma " and

that's why so high. They have since reduced it by $250 but it will still be

hard to pay. And we wonder why insurance premiums are so high??? Bleh. I

hate it.

KC

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