Will BCBS of GA ppo pay for body lift or tummy tuck? I'm 31 year old female have lost over 160 pounds (Photo)

my emotions I feel disgusting and self-conscious. I do skin boil us lots of acne yeast and general uncomfortable from all this can I carry around I am very thin yet underneath our role I do wear a girdle and most of the time to try to hide it I'm sick of it. Even my thighs are affected and my arms I have lost over the years a total of 160 pounds no matter how much I work out my schedule will not snap back into shape I have Blue Cross Blue Shield of Georgia the PPO open sccess

Doctor Answers 4

Insurance coverage of recontruction after massive weight loss.

Insurance may not cover a full tummy tuck, but you may get coverage for a panniculectomy,  which is removal of the redundant skin of the lower abdomen, without the plication of the muscles or relocation of the belly button. You need to have all your symptoms well documented by your PCP and pictures that show the severity of the skin problems. On some occasions even a thigh lift and brachioplasty can be cover if the patient has hidradenitis, which is inflammation of the sweat glands. Consult a Board Certified Plastic Surgeon with in your plan who has experience in weight loss patients. They can help you through the process.

Lower body lift and insurance coverage

Thank you for asking about your lower body lift.
  • You are correct - your skin cannot snap back, no matter what you do, after losing so much weight.
  • BC/BS of GA may or may not pay for surgery -
  • Usually for a panniculectomy, they require excess skin below the pubic area.
  • However you may qualify based on the yeast infections and discomfort.
  • See a plastic surgeon for an exam - and letter of predetermination.
  • Your insurance may have plastic surgeons on the panel who accept BC/BC Payment -
  • Many do not because it is a very very diffcult company to work with from a provider point of view.
  • However even out of network, if surgery is approved, your hospital costs are covered, so are any complications and your will be partially reimbursed for the surgeon's fee if you pay out-of-pocket.
  • Hope this helps!
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Will BCBS of GA ppo pay for body lift or tummy tuck? I'm 31 year old female have lost over 160 pounds

Usually not a covered benefit or only very partially covered. You still will need to pay out of pocket $

Insurance coverage for tummy tuck or body lift?

Thank you for including a photograph and kudos for attaining such a tremendous weight loss!  Insurance companies vary in their coverage for body contouring after weight loss.  They will sometimes cover a panniculectomy (removal of overhanging abdominal tissue apron) when there is recurrent infection or skin breakdown that cannot be effectively controlled by more conservative means (topical anti-fungal creams/powders, etc.), or when there is an underlying hernia.  This is not a cosmetic procedure--it does not remove the maximal amount of skin, and it does not tighten the separated muscles of the abdominal wall.  Insurance companies almost always exclude procedures like a tummy tuck or body lift, which do remove larger amounts of skin and restore the integrity of the muscles.  From your photographs, you would benefit much more from a tummy tuck or body lift because they are much more powerful procedures to re-contour the tissues to your frame.  My best advice is to obtain a copy of your insurance policy (either hard copy or online), and read through the portions relevant to panniculectomy and cosmetic procedures so that you know what is covered.  Schedule a consultation with a board-certified plastic surgeon with this knowledge in hand.  Although ultimately this may be an out-of-pocket expense, many plastic surgeons have other financing options such as CareCredit.  My best wishes to you as you navigate your way through all of this!

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.