Hi I’m a 32 y/o female who lost 200 pounds from weight loss surgery in 2019. I have extreme excess skin in my upper arms & arm pits. I have BCBS IL PPO and I was denied this procedure because it was cosmetic. I am looking to appeal. What can I do to plead my case & get this reversed? I know other people got this covered with BCBSHMO so I’m not sure why I’m being denied. I have scoliosis & see a chiropractor weekly. Can I ask them for a referral as weight from excess skin is causing back pain?
Answer: Will insurance cover my arm lift after extreme weight loss? Congrats on your weight loss! Generally speaking, body contouring after weight loss- including arm lift- are considered Cosmetic and have no medical reason to perform. There is no bodily function that is impaired by having loose, flabby, medial arm skin. There is no question that this will improve appearance of the arms, provided the scar permanency can be accepted. I am not familiar with any clinical studies that support back pain caused by medial arm excess. Best to save your money and see a Board Certified PS - a Member of American Society of Aesthetic Plastic Surgery
Helpful 2 people found this helpful
Answer: Will insurance cover my arm lift after extreme weight loss? Congrats on your weight loss! Generally speaking, body contouring after weight loss- including arm lift- are considered Cosmetic and have no medical reason to perform. There is no bodily function that is impaired by having loose, flabby, medial arm skin. There is no question that this will improve appearance of the arms, provided the scar permanency can be accepted. I am not familiar with any clinical studies that support back pain caused by medial arm excess. Best to save your money and see a Board Certified PS - a Member of American Society of Aesthetic Plastic Surgery
Helpful 2 people found this helpful
Answer: Arm Lift Coverage with Insurance Thank you for your question regarding insurance coverage for an arm lift after significant weight loss. Insurance policies vary greatly, and the coverage is often determined by the specifics of your plan and the criteria set by the insurance company. A universal standard for coverage doesn't exist across all insurers. Some might cover the procedure in certain circumstances, while others may not. Typically, for insurance to consider covering an arm lift, there needs to be evidence of a functional impairment caused by the excess skin, such as persistent rashes or limitations in arm movement.
Helpful
Answer: Arm Lift Coverage with Insurance Thank you for your question regarding insurance coverage for an arm lift after significant weight loss. Insurance policies vary greatly, and the coverage is often determined by the specifics of your plan and the criteria set by the insurance company. A universal standard for coverage doesn't exist across all insurers. Some might cover the procedure in certain circumstances, while others may not. Typically, for insurance to consider covering an arm lift, there needs to be evidence of a functional impairment caused by the excess skin, such as persistent rashes or limitations in arm movement.
Helpful
September 27, 2021
Answer: Will insurance cover my arm lift? Congratulations on your impressive weight loss! Unfortunately an arm lift is considered cosmetic and therefore is not covered by insurance. It would be a difficult argument to win that loose upper arm skin would cause medical concerns. Perhaps talk to those you know who had it covered? Maybe they can provide some insight on what to include.
Helpful
September 27, 2021
Answer: Will insurance cover my arm lift? Congratulations on your impressive weight loss! Unfortunately an arm lift is considered cosmetic and therefore is not covered by insurance. It would be a difficult argument to win that loose upper arm skin would cause medical concerns. Perhaps talk to those you know who had it covered? Maybe they can provide some insight on what to include.
Helpful
August 6, 2021
Answer: Will insurance cover my arm lift after extreme weight loss? You should get in touch with those ladies who were able to have insurance cover their arm lifts as they may be able to provide you with the reasons they submitted on their pre-authorization paperwork. Arm lifts are considered cosmetic and will not be covered for extreme weight loss. Extended arm lift (down to the inner aspect of the upper arm) may cost between $8000 and $11,500.
Helpful
August 6, 2021
Answer: Will insurance cover my arm lift after extreme weight loss? You should get in touch with those ladies who were able to have insurance cover their arm lifts as they may be able to provide you with the reasons they submitted on their pre-authorization paperwork. Arm lifts are considered cosmetic and will not be covered for extreme weight loss. Extended arm lift (down to the inner aspect of the upper arm) may cost between $8000 and $11,500.
Helpful
August 5, 2021
Answer: Insurance Coverage for Arm Lift Dear Deltadanielle:I understand your problem, and it is more common than not. I practice in Oregon and have a large bariatric practice and rarely can get arm lift authorized by insurance. You can appeal, but I would prepare you that the answer will still be no. It is frustrating.Sincerely,Dann Leonard, MD
Helpful
August 5, 2021
Answer: Insurance Coverage for Arm Lift Dear Deltadanielle:I understand your problem, and it is more common than not. I practice in Oregon and have a large bariatric practice and rarely can get arm lift authorized by insurance. You can appeal, but I would prepare you that the answer will still be no. It is frustrating.Sincerely,Dann Leonard, MD
Helpful
July 30, 2021
Answer: Appeal for body contouring I recommend start saving for the procedure as this cosmetic. Those who got this covered must have had different complaints or someone in the process exaggerated or simply fraudulently claimed that they had a medical condition related.
Helpful 1 person found this helpful
July 30, 2021
Answer: Appeal for body contouring I recommend start saving for the procedure as this cosmetic. Those who got this covered must have had different complaints or someone in the process exaggerated or simply fraudulently claimed that they had a medical condition related.
Helpful 1 person found this helpful
