Question:
Isn't abdominalplasty surgery considered medically neccessary after losing a lot of

weight? Should I pay a deposit or look for another doctor? I called my doctors office to see about getting an abdominalplasty surgery done at the same time of my hernia repair. Well the lady told me that i may have to pay a deposit. I told I have an hmo and that since I have a hernia i assume that it would be medically neccessary to have it done at the same time of my abdominalplasty. I have united healthcare select. I called the insurance company and they told me that it would be covered if it is medically neccessary. She said all the doctor had to do is call and get it precertified.    — [Anonymous] (posted on March 10, 2001)

March 10, 2001
Here's a web address: http://www.plasticsurgery.org Check out the Plastic Surgery - Recommended Criteria for Third-Party Payer Coverage. It may supply you with some of the information you need. As far as the financial aspects, I'm sorry I can't help as I have no information. Best of luck!
   — Lynn E.

March 10, 2001
You're absolutely right. Follow Lynn's links for the Plastic Surgery Position Paper of '94 -- Reduction of Redundant Skin to Attain a Normal Appearance after Massive Weight Loss. It took much research and I feel lucky to have found a plastic surgeon (after 3 different consults) who is willing to submit and work with the insurance companies towards getting all these procedures covered. So far I have had my brachioplaty (arms), mastoplexy (breasts) and abdominoplasty (stomach) covered, and am currently awaiting approval on my inner thighs and lower body lift. The insurance company has been wonderful. However, most of the plastic surgerons I consulted with and hear about prefer IMHO to think of us as cash cows and can't be bothered to even submit. After losing 170 lbs in a little more than a year, I do not appreciate being treated like a vain woman who needs a little tune up in the tummy and has to be prepared to pay through the nose. Attaining normal appearance when you have miles of redundant skin draping off our bodies is medically necessary if for no other reason that attaining normalicy is vital to our self esteem. Not everyone needs all of the procedures that I have and will have, but those of you who need or desire them should have them available to you through insurance coverage. Get proactive, as we did with our WLS, and get a plastic surgeon who will accept the assignment. Mine has gotten very nice surgical fees for my reconstructive surgeries. Good luck,
   — Jill L.

October 2, 2005
Finally...I got my "Tips for Getting Your Plastic Surgery Approved" worksheet on my website. It will help individuals who have medically necessary issues get their plastic surgery covered, at least in part, by insurance. Check www.drlomonaco.com under "Patient Resources"
   — DrL

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