How To Get A Panniculectomy Covered By Insurance

Contact your health insurance provider to discuss your payment options. The cost can range from 8000 to 15000 plus anesthesia and other extras.

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I have gotten CPB for the WLS for my gall bladder removal for the panniculectomy and abdomniplasty.

How to get a panniculectomy covered by insurance. To be considered medically necessary usually the pannus must extend past the pubic area and may be causing issues with function. When it comes to potential insurance coverage your description of your pannus sounds like it would not qualify. Also most insurance companies require a stable weight for 6 months if you lost weight through diet and exercise and for 18 months if you lost weight through gastric surgery.

Does insurance pay for skin reduction surgery. While a panniculectomy is considered a medical necessity after a significant amount of weight loss a tummy tuck is an elective procedure for cosmetic reasons. Does BCBS cover Panniculectomy.

The panniculectomy also may be covered if the pannus completely covers your pubic region. How much does trip insurance cost. How can I get my insurance to pay for a tummy tuck.

If the skin hangs below the pubic bone and rashes occur insurance may pay for a panniculectomy. Some will pay for the excess skin removal. 5 of these Guidelines.

The rest is on your dime. According to survey responses from plastic surgeons the highest ranking criteria for panniculectomy coverage were Patient is weight stable for at least 6 months and Patient must be at least 18 months post-bariatric surgery These criteria were required by only 413 and 397 of insurance providers respectively. What insurance pays for cosmetic surgery.

When a panniculectomy is being performed at the same time as bariatric surgery. Since you or someone is paying for this insurance they have to have in writing somewhere what the policy is. You might be interested.

This is not a cosmetic procedure though. Now - youll probably only get the panniculectomy paid for. Tips to get insurance to cover your surgeryThanks for watching and.

Dont forget to subscribeI do not own rights to this music- Wavy- SZAFAQs- Surgery htt. Since the panniculectomy is not typically seen as a cosmetic surgery your insurance provider may help pay for the procedure. Panniculectomies and tummy tucks are used to get rid of excess skin around the lower stomach after losing weight.

If you call your insurance rep they might be able to sendfax you there version of this document. Panniculectomy and lipectomy surgeries are covered by ForwardHealth with prior authorization PA. Since the panniculectomy is not typically seen as a cosmetic surgery your insurance provider may help pay for the procedure.

One of the clear insurance coverage criteria for an abdominal panniculectomy is that the pannus hangs over the groin crease onto the thighs. A tummy tuck is less. But you must meet.

This ForwardHealth Update introduces new PA approval criteria for panniculectomy and lipectomy surgeries effective for PA requests received on and after February 3 2014. A panniculectomy is more expensive than a tummy tuck but its often covered by medical insurance. Of course I went with the one that said they would - and they did.

Its all how the Drs bill it - but of course like the others said some insurance companies just dont cover it - no matter what. Because surgical outcomes are superior when performed in patients who have achieved a stable weight BCBSNC requires that stable weight be obtained prior to authorization of coverage for panniculectomy surgery except in rare unusual cases. Only a panniculectomy or amputational abdominoplasty will work.

The majority of requests for coverage for panniculectomy are for patients who have sustained significant weight loss or who remain morbidly obese. This is a surgical problem. The full abdominoplasty or tummy tuck is almost never covered but inquiry on an individual basis does occur.

But you must meet specific criteria and the panniculectomy must be seen as a medical necessity. When a panniculectomy is being performed to prevent hernia occurrence or to prevent hernia recurrence in conjunction with a hernia repair unless the member meets the criteria for panniculectomy stated in Section II. Unlike traditional insurance plans Medicare does not have a system where we can determine prior to your procedure if an abdominoplasty or panniculectomy will be covered as a medically necessary procedure.

Whether or not your insurance will cover the procedure depends on whether it is considered to be medically necessary or cosmetic. This is why Medicare does not simply pay for all of these operations.

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