I’m over weight been that way all my life. I have a bad over hang. I also have a bad back I have spinal stenosis. I feel like my overhang makes my back hurt worse. I know that the insurance company thinks it cosmetic, but if my over hang is hurting my back, do you think they would pay for it? I have lots of paper work from my doctors. I’ve had this back issue for many years.
August 12, 2018
Answer: Abdominoplasty insurance Coverage: Information Dear Ms. Pattistengel, I appreciate how you feel and thank you for your story and questions. Unfortunately with out photos and a exam of your tissues I can can only comment based your story, however I hope you find my comments helpful.Based solely on your story you may benefit from a panneculectomy (removing just the overhanging tissue) than a full abdominoplasty. If I understand your question (rephrased: "will insurance cover the costs to make my breasts normal again". And how do I “find” a Plastic Surgeon who will accept my insurance. Each insurance company covered benefits are a little different how ever most follow the guidelines of the American Medical Association. Likewise, each physician (despite specialty)make decisions which insurance companies they will contract with based on many factors. I have copied directly from the American Medical Association (AMA) (1) Our AMA supports the following definitions of "cosmetic" and "reconstructive" surgery: Cosmetic surgery is performed to reshape normal structures of the body in order to improve the patient's appearance and self-esteem. Reconstructive surgery is performed on abnormal structures of the body, caused by congenital defects, developmental abnormalities, trauma, infection, tumors or disease. It is generally performed to improve function, but may also be done to approximate a normal appearance. (2) Our AMA encourages third party payers to use these definitions in determining services eligible for coverage under the plans they offer or administer.(CMS Rep. F, A-89; Reaffirmed: Sunset Report, A-00; Reaffirmed, A-03; Reaffirmed: CMS Rep. 4, A-13). If you don't qualify you could consider: 1) start a separate savings account (deposit any extra cash or gifts) and watch it grow. 2) ask a different relative (who has good credit scores to counter sign for you) 3)take on a separate job just to add to your separate savings account. 4)Set up “A go fund me account”. 5)if you live near a University Medical Center, seek out the Plastic Surgery Residents in training. They often discount their services significantly. 6)ask if any in (5) above have seasonal discounts or specials. Thus, I suggest you make several appointments with experienced Plastic Surgeons who listens to your specific desires and who are not only Certified by the American Board of Plastic Surgery but in addition ideally a member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery). My best wishes, Dr. R. A. Hardesty, MD, FACS Diplomate and Certified by the Am. Bd. of Plastic Surgery Awardee: RealSelf Top 100 wwwimagineplasticsurgery.com 4646 Brockton Ave Riverside, Ca 92506 (951) 686-7600
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August 12, 2018
Answer: Abdominoplasty insurance Coverage: Information Dear Ms. Pattistengel, I appreciate how you feel and thank you for your story and questions. Unfortunately with out photos and a exam of your tissues I can can only comment based your story, however I hope you find my comments helpful.Based solely on your story you may benefit from a panneculectomy (removing just the overhanging tissue) than a full abdominoplasty. If I understand your question (rephrased: "will insurance cover the costs to make my breasts normal again". And how do I “find” a Plastic Surgeon who will accept my insurance. Each insurance company covered benefits are a little different how ever most follow the guidelines of the American Medical Association. Likewise, each physician (despite specialty)make decisions which insurance companies they will contract with based on many factors. I have copied directly from the American Medical Association (AMA) (1) Our AMA supports the following definitions of "cosmetic" and "reconstructive" surgery: Cosmetic surgery is performed to reshape normal structures of the body in order to improve the patient's appearance and self-esteem. Reconstructive surgery is performed on abnormal structures of the body, caused by congenital defects, developmental abnormalities, trauma, infection, tumors or disease. It is generally performed to improve function, but may also be done to approximate a normal appearance. (2) Our AMA encourages third party payers to use these definitions in determining services eligible for coverage under the plans they offer or administer.(CMS Rep. F, A-89; Reaffirmed: Sunset Report, A-00; Reaffirmed, A-03; Reaffirmed: CMS Rep. 4, A-13). If you don't qualify you could consider: 1) start a separate savings account (deposit any extra cash or gifts) and watch it grow. 2) ask a different relative (who has good credit scores to counter sign for you) 3)take on a separate job just to add to your separate savings account. 4)Set up “A go fund me account”. 5)if you live near a University Medical Center, seek out the Plastic Surgery Residents in training. They often discount their services significantly. 6)ask if any in (5) above have seasonal discounts or specials. Thus, I suggest you make several appointments with experienced Plastic Surgeons who listens to your specific desires and who are not only Certified by the American Board of Plastic Surgery but in addition ideally a member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery). My best wishes, Dr. R. A. Hardesty, MD, FACS Diplomate and Certified by the Am. Bd. of Plastic Surgery Awardee: RealSelf Top 100 wwwimagineplasticsurgery.com 4646 Brockton Ave Riverside, Ca 92506 (951) 686-7600
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August 12, 2018
Answer: TT Thank you for the question and the simple answer is Probably not! Medicare and insurance may pay for a panniculectomy if medically necessary (the over hang) but not a full tummy tuck.Dr Corbin
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August 12, 2018
Answer: TT Thank you for the question and the simple answer is Probably not! Medicare and insurance may pay for a panniculectomy if medically necessary (the over hang) but not a full tummy tuck.Dr Corbin
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