POSTED UNDER Panniculectomy REVIEWS
Panniculectomy - Winston Salem, NC
ORIGINAL POST
Hi everyone! My name is Lori and I had a lap band...
WORTH IT
Hi everyone! My name is Lori and I had a lap band in 2009 and have lost approximately 60 lbs. I have a Grade 4 (hangs mid thigh) pannus that I plan on having removed. I am having to write to my insurance company Cigna to see if they will grant prior-authorization, if not I will have to pay ~$10,000 out of pocket. I plan on mailing my letter and all of my supporting documents by the end of this week or early next week. Has anyone here had any experience with Cigna? Also, I would love to hear your experiences. I love reading all of the posts on here!
Thanks,
Lori
Thanks,
Lori
loriw78's provider
Replies (5)
September 23, 2013
Hope all will work out for you. My apron covers my mons pubis and I was approved by BCBS. Wshing you luck!
September 23, 2013
My insurance paid for the panni part and I paid the rest. I didn't have muscle repair but did the rest of a tt. Without a doubt I think your insurance will approve you. I had lap band too. And lost 80 pounds. You are gong to feel like a new woman. I am very excited for you and can't wait to see your updated after pictures.
January 14, 2015
Good Luck to you. My friend is having a bariatric procedure and she's lucky that our insurance company (Oxford) pays for the Corrective surgery to remove the excess skin. I seems like such a no brainer, with that much weight loss there is bound to be a great deal of skin that will need correcting.
December 10, 2015
Hi Lori! Congrats on the weight loss. I do not have signa but have anthem blue cross and have recently been approved for a panniculectomy which is scheduled December 26th. They covered about half of it and I am still responsible for 5k of the procedure as they cover only the minimum. I lost 65 250-185lbs through diet and exercise and have kept it off for 14 years. I know most insurance plans want a minimum of 100 lb weight loss for at minimum a year if you lost the weight by weight loss surgery. Good luck!
UPDATED FROM loriw78
3 months pre
Now the waiting begins...
I mailed my paperwork to Cigna on Friday (9/20/13) now I just have to wait patiently for an answer. I have faith that this is going to work out in my favor!
Replies (0)
UPDATED FROM loriw78
3 months pre
I pray it's only a road block ....
I spoke with my insurance company today (Cigna) and they told me that they do not accept clinical notes from patients that they will only accept it from a doctor ... not sure how to proceed now. I guess I will have to let my plastic surgeon know and see if he will be willing to submit it on my behalf.
Replies (14)
September 26, 2013
I'm surprised your Surgeon didn't submit all the photos & notes for you - that's usually how it's done. I don't have any experience w/Cigna but I don't see why you would not qualify, though each insurance company is different. Mine covered mine & a breast reduction but I had to fight 1 appeal on the Panni, they wanted "photos" ok fine, should have asked for that in the first place, duh lol - anyway, congrats to each & every single one of you on your weight loss, we all know how difficult it is & we all know how good our new bodies feel after we get these much deserved operations!
September 27, 2013
I hope you get approved! I lost 127lbs and luckily I was approved by my insurance, and again approved now for my breast lift/revision tummy tuck. I'm sure the plastic surgeon would submit that stuff for you! Keep us updated!
October 3, 2013
Hi! I've lost 123 pounds and I'm undecided about getting a panniculectomy or a lower body lift. I believe I'm a grade 3. I also have had trouble getting a straight answer about a panniculectomy. I talked to my insurance and they told me to talk to my doctor. My Internal Doctor told me to talk to my Family Doctor, he didn't know of any plastic surgeons so I should talk to my vertical sleeve surgeon. I also talked to my Dermatologist and he suggested I speak with my Family Doctor. I then talked to a plastic surgeon and said I should get a lower body lift, a panniculectomy will leave me with dog ears and he wanted to charge $23,000! I don't know what to do?
October 3, 2013
Oh my goodness it sounds like you are getting the run around. I pray that you find a good surgeon soon. Try to make sure you get one that is board certified in plastic surgery. If they know what they are doing they should be able to prevent the dog ears with a panniculectomy.
October 3, 2013
Yes, they are giving me the runaround. Right now I don't mind too much because it hasn't been a year yet since I've been sleeved. That will be at the end of January. But I would like to know my options and how much I need to save. I do have my sleeve surgeon to talk to also, maybe I'll wait til next year.
October 3, 2013
I lost 80 lbs with help from a lap band. I went to a plastic surgeon to find out about a panniculectomy. He actually did the paper work that the insurance needed to get approval. I ended up having a modified tummy tuck, which is what my ps called it. It was a panniculectomy and partial tt at the same time. If you have a panni only they will remove only the pannus, the skin below the belly button. I opted for the modified because I wanted my skin pulled tighter from the top of my tummy down and wanted a new belly button. I didn't have muscle repair but now wish I had. Still my insurance did approve the panni and paid 1100. on the bill and I ended up paying the rest. It was well worth it to me. Oh and I did have dog ears after my surgery, however you need to know it is not a big deal to fix at all. I went in the office and had it done and they are totally gone. I actually could have not had them fixed and no one would have ever known except me. As far as the cost I think that 23,000. is crazy. Please try to find a board certified plastic surgeon in your area. See several I am sure you will find one that will do it for much less than that. I called my lap band doctor for the name of a plastic surgeon, and they did give me the name of the one I ended up with. Maybe give yours a call. They know some I am sure. Hope you get this done for yourself, I don't miss that apron (pannus) of skin hanging off my body at all. Or the infections, or any of the pain that went along with it. It really is awesome to take a shower and not have to lift any skin up to clean under. Have a great day!
October 5, 2013
Congrats on your weight loss! I was gonna ask the plastic surgeon if he could just do a panniculectomy but I could tell he was against it. I will need a new belly button too. I'll probably give my sleeve surgeon a visit but not til January when I've completed a year. This is the surgery I've been waiting for over half my life. Thanks for all your helpful info!
October 5, 2013
My PS is going to give me a new belly button with my panniculectomy. I think that part varies from surgeo to surgeon but I am glad mine includes it. Good luck on everything!
October 6, 2013
It varies from surgeon to surgeon because Insurance companies consider that "cosmetic" as unreal as that sounds - good for you! Mine gave me a belly button too - I LOVE my surgeon!
October 6, 2013
Go to your Insurance provider's website, see if they cover Breast reduction (most do) then try to get a consultation with THAT surgeon & talk to him about your options for a panniculectomy, since he or she already works w/your insurance provider chances are you will get further faster - it still won't be cheap, Insurance won't pay for lipo & some other things they consider cosmetic but that is where I discovered how to get my breast reduction & panniculectomy done at the same time by the same surgeon & Insurance paid for all but the lipo!
November 5, 2013
My insurance paid formy panniculectomy and breast reduction...i paid 1,000.00 for them to pull down skin and give me new belly button...when i asked how much it would be extra to Full tummy tuck, they quoted me almost 6,000.00 if you have the cash get the full tummy tuck....i didnt have it so i just got panniculectomy and new belly button...but honestly i feel sooooo much better. And i feel better with my blobby stomach flap gone.
January 14, 2015
He should be able to. I don't understand why he wouldn't help you with that especially since it's likely he could get the business! Keep thinking positive. It will happen!
Hi there, welcome and thanks so much for sharing your journey with us!
Congratulations on your weight loss, that's a huge achievement and something you should be really proud of! Good luck with your insurance, I hope you get quick approval. Please do keep us updated with your progress!