Frustation?

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    Apr 28, 2008 11:59 PM GMT
    So how do I take this? I want plastic surgery to fix my loose skin around my torso and I got the first "denial letter" in the mail today. They were pretty dirrect about why they denied the claim....and said "you are not in bad shape"....do I take this as a "compliment"? I am obviously going to appeal this, because it hasn't ever been about "appearences", but health issues. Still, I have to laugh at the almost "Far Side" hyperbole, that I am being forced to take to justify having the surgery.... After the $250,000.00 they have paid so far to get me this far, why do they want to fight with me now over finishing the job? icon_question.gificon_lol.gif
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    Apr 29, 2008 1:22 AM GMT
    $250,000 so far? That's a butt load of money. Did you have gastric by-pass?
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    Apr 29, 2008 5:14 AM GMT
    polobutt said$250,000 so far? That's a butt load of money. Did you have gastric by-pass?


    YES....lost 240 lbs...
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    Apr 29, 2008 5:50 AM GMT
    Are you talking about your insurance company paying out $250,000 ?
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    Apr 29, 2008 11:21 PM GMT
    redheadguy saidAre you talking about your insurance company paying out $250,000 ?


    Yes. Insurance has paid out just under $1/4 million for my weightloss surgery, "pre-surgery education", surgery to fix the 6 abdominal hernias and the special dietary supplementation I still require, along with regular bloodwork and dr. checkups, etc.....
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    Apr 29, 2008 11:49 PM GMT
    How much does the "skin" operation cost?
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    Apr 30, 2008 12:53 AM GMT
    sporty_g: I am assuming you have private coverage, right?

    Regardless, I imagine you have a significant amount of loose skin at various locations on your body. With that said you can emphasize that with the loose skin comes rubbing and chafing, which then leads to more significant problems, such as ulcers on the skin. So basically one problem deemed "minimal" by your health insurance company can snowball into major health problems.

    So I say all that to say you should emphasize that over simply just finishing what was started.


    Best of luck to ya!
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    Apr 30, 2008 1:11 AM GMT
    You've gotten a quarter of a million dollars out of your insurance company for weight loss surgery and your claiming more.......for cosmetic surgery


    My health insurance premium is quintupling next year

    I can safely say I'm feeling a little frustrated
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    Apr 30, 2008 5:43 AM GMT
    AMT87 saidYou've gotten a quarter of a million dollars out of your insurance company for weight loss surgery and your claiming more.......for cosmetic surgery


    My health insurance premium is quintupling next year

    I can safely say I'm feeling a little frustrated


    ha...I was trying really hard not to focus on just that. I guess when one has that much to lose, the procedure he/she might want to have is deemed more of a necessity...thus it is no longer considered under the realm of cosmetic surgery.

    But yeah...I understand your frustration!
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    Apr 30, 2008 6:01 AM GMT
    Pay for the surgery you want out of your own pocket.
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    Apr 30, 2008 7:21 AM GMT
    I'm an assistant to a Plastic Surgeon and I can tell you that depending on the amount of extra skin you will have, the insurance company won't see paying for an operation that isn't a possible, "health risk." Your best bet is to pay for the surgery yourself. A good surgeon will do it for around $6,000. That usually includes liposuction, removal of lose skin and anesthesia.