Insurance Pay for PS???

renewedhope · 03-30-2008, 01:18 PM

I have been told that some insurance companies will pay for ps after weight loss. I called mine and they said that the docotor would have to send in request for coverage. The lady said that while it may be medically necessary for some, it may not be for others. Has anyone ever had insurance pay for their ps and what "symptoms" would make it medically necessary. I would love to get this part of my journey covered by insurance if that is a possibility.
Thanks,
Amy

StephC · 03-30-2008, 04:44 PM

My insurance is covering it - you must show medical necessity. So if you have rashes or skin irritations, tearing, if it hinders your exercise. I only expected to have the pannectolmy covered but my insurance is also paying for my tt. I talk more about it on my thread - StephC's journey/I'm approved!

Boo Boo Kitty · 03-30-2008, 04:52 PM

My insurance is paying for mine as well as a breast reduction. I have a rash because of the skin as well as many rips in the skin where it gets caught in my jean zipper. (Hurts like hell) Also low back pain helped me.

renewedhope · 03-30-2008, 10:44 PM

Thanks so much. Steph, I read your thread. I have those rashes as well. Like you said in your thread, I can live with them, but the insurance company doesn't have to know that. I also have low back pain and mid back pain. It doesn't stop me and i don't go to the doctor for it, but it is there. Boo Boo, I have also zipped my tummy in my pants and yes it does hurt like hell. Thanks you guys. I am very hopefull that it will be covered. I don't plan to go for a consult until I am at 150, so I have a way to go, but I am planning for the cost of it now. Thanks so much!!

Amy

StephC · 03-31-2008, 08:39 AM

Amy - I would call now to see how long it would be to get a consult. That really messed me up on my schedule. I called way back in Oct and couldnt' get in with the ps of choice until the end of Jan - then I had a couple more visits so from first call to surgery took 8 months. 8 months that you'll be losing weight.

Boo Boo Kitty · 04-03-2008, 04:26 AM

Quote:

Originally Posted by StephC

Amy - I would call now to see how long it would be to get a consult. That really messed me up on my schedule. I called way back in Oct and couldnt' get in with the ps of choice until the end of Jan - then I had a couple more visits so from first call to surgery took 8 months. 8 months that you'll be losing weight.

It took me that long as well. Plus you can shop around and find the right surgeon for you! Good luck!

renewedhope · 04-03-2008, 07:46 AM

Well, I signed up to run a 5k in May and am working my butt off at the gym(hopefully literally). I will go ahead and schedule the consult. I hope to be ready for surgery by the end of the year.

Amy

StephC · 04-03-2008, 08:56 AM

good luck Amy. Theres no time like the present.

mbanja · 04-03-2008, 11:46 AM

So, I'm assuming that if I want to go the insurance route I would go to my pcp who would then refer me to a PS? Is that right. Should I go a couple of times to my pcp to get documentation that rash and lower back pain are occuring? What do you think would be the best. I am so desperate to get rid of my apron I am seriously considering purposely zipping it up in my pants. Whoa that is desperation isn't it. YIKES!!

renewedhope · 04-03-2008, 11:47 AM

If you have ever zipped it in your pants you wouldn't do it on purpose. OUCH!!! LOL It hurts soooo bad. This is a very good question. I am anxious to see what advise you get.

Amy

k_podski · 04-03-2008, 11:54 AM

Great thread! I had no idea that some insurances would cover this?! I guess a BL/ augmentation would be stretching it? I could zip those up in my pants now, never mind a year down the road! lol..

mbanja · 04-04-2008, 07:06 PM

LOL! Kpodski that is too funny! Fortunatly I am one of those fat people with no boobs! My sister got all of them! She could probably zip them up in her zipper too! I hate being fat with no boobs, it just doesn't look right! I was thinking about a boob job after I lost the weight, but now that the weight is comming off I am having second thoughts! My boobs haven't really reduced in size (thank God!) so I am kinda starting to even out. I really just don't think I'd be comfortable with big perky bazookas sticking out. My belly fat and apron could deffinately go though!

HarleyGirl · 04-04-2008, 07:11 PM

Quote:

Originally Posted by k_podski

Great thread! I had no idea that some insurances would cover this?! I guess a BL/ augmentation would be stretching it? I could zip those up in my pants now, never mind a year down the road! lol..

Maybe if we said our droopy, sad boobies are causing us psychological problems........or causing distress to our significant others....?

renewedhope · 04-04-2008, 07:29 PM

From what I understand, if you have rashes under your breasts due the "sagging" then it may be covered.

mbanja · 04-07-2008, 09:12 AM

I would think that sagging breast would cause back pain. That is medical necessity isn't it?