Re: Insurance coverage for reconstructive surgery

[Guest guest]

In a message dated 11/20/03 9:05:09 AM Central Standard Time,

cinburr@... writes:

> so have a choice between Aetna

> and BCBS of Illinois --- both HMOs.

------------

I had Aetna PPO and they covered my tummy tuck (the panni part).

Aetna has pretty straightforward coverage guidelines - <A

HREF= " http://www.aetna.com/cpb/data/CPBA0211.html " >Aetna:

Abdominoplasty/Suction Lipectomy/Ventral Hernia Repair</A> here is the link to

their clinical policy

bulletin on the procedure. I believe these guidelines apply regardless of

whether it is PPO or HMO, unless there is some type of specific exclusion

written

into your policy making it not covered.

Beth

Houston, TX

VBG - Dr. Srungaram

05/31/00 - 314 lbs.

11/01/02 - Abdominoplasty

11/29/02 - 160 lbs.

5'10 "

[Guest guest]

Hi Cindy,

Last December I had my panni done here in Colorado with approval

through BCBS. They had some specific qualifications I had to meet in

order for them to approve it (the big one was being at least 18

months out from the RNY, but also wanted me as close to my " goal "

weight as possible). I got one decline from them because of the 18

month policy, but the second try got approved in less than two weeks

(if I remember the timeline correctly).

Let me know if you have any questions.

Good luck!

-

> Hi all...

>

> Have a couople of questions re: insurance coverage and

reconstructive

> surgery.

>

> Will probably have to switch insurances due to my pcp not accepting

> my current plan, United Healthcare... so have a choice between

Aetna

> and BCBS of Illinois --- both HMOs.