StephC's PS journey/I got approved!!

StephC · 03-11-2008, 11:57 AM

I'm sooooooo excited! I called the insurance co this morning and they said I was approved! Yippee! So then I called the doctors office - I'm really trying to push everyone along so I can get it all done before April 1st - the dr's office said they had me in their pile to set up the surgery date and they would be calling me with a date. I said I hate to be pushy but... and I also know its really crazy to think they can get to me so soon but she said it all depends on the hospital schedule. Actually I am very hopeful because the hospital I'm having it done at is a small hospital and its very possible they'll be able to get me right in.

Pray for me!

KarenG. · 03-11-2008, 12:16 PM

Could you tell me what insurance you have and how you got approved and for which procedures? Thanks!

juliegeraci · 03-11-2008, 12:57 PM

Steph, that is great news. I don't know if my insurance covers plastic surgery or not.

StephC · 03-11-2008, 02:20 PM

I have UPMC. I had to show proof of a medical need. So when I went in I told the doctor that I get a rash thats like athletes foot, I use a cream for athletes foot on it. I told him that when I roll around in bed it feels as if I might tear the skin, and that I can't jog because the flap slaps as I run, someone else said to tell them you have lower back aches, which I do but forgot to tell them about that. So he took pictures and he was concerned that I still had 20 lbs to lose to be in the 'normal' bmi but I guess I was close enough that they decided I needed it done. I thought it would just be the pannectomy (apron removel) but the doctor said he will do a full tummy tuck.

This was the 2nd doctor I saw, the first guy didn't even want to talk insurance, and his price was $10,000, he also wouldn't talk the apron removal, he insisted I needed the full tt. I will admit his facility was above standard, very classy. This doctor said we will get the insurance approval first, he would put in for a full tt and see what they would cover. He said he wanted them to at least cover the apron removal so that the hospital bill would be paid and most of his fee, but it doesnt' look as if we will need to worry about that.

I think most insurances will cover ps if there is a medical need. Good luck! And good luck finding the right doctor who is willing to work with you.

KarenG. · 03-11-2008, 02:30 PM

Thanks for your response. I have to call my insurance company and get some info from them. I get the occasional rash under my stomach - I actually thought to take a pic last time. THey are pretty tolerable though between you and me. I also find running increasingly difficult because of the swinging skin and need to wear super duper spandex to keep things from flying away. Finding other things uncomfortable with the skin on butt - won't get to graphic here. Anyway I hope that combined with the need for a hernia repair my insurance company will cover some of my costs. Good luck to you and keep us updated on your progress!

make33 · 03-11-2008, 02:57 PM

What fabulous news for you Steph!!

Hey, your "UPMC"--is that as in the Western Pennsylvania UPMC??????? That's MY insurance company! Maybe there is hope for my flabby belly after all (when I reach goal)... I sure hope it is the same!

StephC · 03-11-2008, 02:58 PM

Karen it sounds like you'll qualify. And between you and me I also could tolerate the rashes. I actually haven't gotten any for a while since I've been using deo under my apron, but they dont' need to know that. And I also us the spandex, I love the spanks, and wear them all the time to "trim" me up. :)

StephC · 03-11-2008, 02:59 PM

Make33 - yes it is western pa - where are you from? I'm between Johnstown and Somerset and will be having my surgery in Windber.

make33 · 03-11-2008, 03:09 PM

OMG, what a small world! I''m about 50 miles north of Pittsburgh--had my surgery in Greenville (next to the Ohio border)!! UPMC covers a LOT of territory now, doesn't it?!!

PS We Quad Ride in Somerset a few times a year!

StephC · 03-11-2008, 03:39 PM

Make33 - tell me where you ride quads at in Somerset County? Talk about a small world. Theres a HUGE quad park behind my house, Reels Corner is the crossroads of rt 160 and rt 30. They have these big quad fests there a few times a year. If thats where you went you had to have driven past my house.

make33 · 03-11-2008, 05:29 PM

Well then, I'm going to bet we have driven past your house numerous times!! The place where we go is called Mountain Ridge Trails--is that the same place?

All I know is that we went to a Quad Fest in 2005 with friends and had a great time--except for the 4000+ people that they say were there!

Since then, we get an annual pass and do four-day weekends twice a year (we also go to a place in Bradford) there--really a good place to ride quads.

Best of luck with your upcoming (soon I hope) surgery, Steph!

**losingjusme** · 03-11-2008, 05:47 PM

Steph,
congrats on being approved. hope you can get the date you want!! :)

**Kat817** · 03-11-2008, 06:00 PM

How long after the Dr.'s visit did you wait to call insurance? I am like you, I don't want to piss anyone off being pushy, but I wanna yell at them to HURRY!!!!!!!!!!!!! LOL So glad you understand!!!

Kat

StephC · 03-11-2008, 06:02 PM

thanks LJM! I'm praying!

Make33 - yep thats right behind my house. I actually walk around some of those roads. Its a killer walk with all the hills aka MOUNTAINS! Next time you're up this way you WILL stop and visit me.

StephC · 03-13-2008, 06:17 PM

Hey Kat - sorry I missed your post. Well I waited one week the first time I called. From Monday to Monday - they said they hadnt' received anything from the dr. so then I called the dr and they said they had just sent everything over on Thursday and the ins. just may not have opened it yet. So I waited until Friday and called the ins. co, they said they had gotten everything and that it would be up to 7 days, so then I waited until the following Tuesday and they said I was approved. I called the dr and they said I was in the pile to be scheduled. The next day they called and said there was a problem with the insurance codes - that was yesterday - what a freaking roller coaster! Today they called and said ALL was approved and the dr wants to see me before we schedule to talk about additional weight loss. BS! I told dh I'm going to tell him I'll do a pre-op diet if he wants but I'm 15 lbs from goal, this isnt' going to hold me up. My dh is happy with me the way I am and I am too, I just want this flap of skin gone, if it takes me 3 years to lose 15 lbs so be it.

I guess you didnt' ask for all that. :)