I had gastric bypass surgery in 2009 and 2 hernia surgeries since. Can my insurance pay for this surgery? I have so much skin hanging from loosing weight from the surgeries
Whether or not they will pay depends on how long your weight has been stable, the amount of hanging skin and if you have had infections or maceration of the hanging skin that did not respond to medical and hygiene treatment. The details depend on the specific wording of your insurance policy. Typically they will first want a preauthorization letter from your surgeon and photos to document the medical necessity of the surgery. That covers the panniculectomy or removal of skin below the belly button. If you have recurrent hernias they may pay for an entire abdominoplasty including removal of skin above and below the belly button level and suture tightening of the abdominal muscles. Again that depends on the specifics of your policy.
Some insurances in California will cover removal of the excess skin in the lower abdomen after massive weight loss. As Dr. Stone mentioned, the patient usually has to have symptoms related to the overhanging skin, like rashes or red skin or wounds that you can't control with creams and good hygiene. Anthem Blue Cross, for instance, requires patients to have lost over 100 pounds and maintain their current weight for one year. You can call the Customer Service number on the back of your insurance card and explain your situation. They can tell you if panniculectomy is a "covered benefit". Panniculectomy does not include repositioning of the belly button, tightening the abdominal wall, or getting rid of any skin excess above your belly button, but it does get rid of the hanging "apron" of lower abdominal skin. If you want a more "cosmetic" repair, then you may have to pay for an abdominoplasty privately. Consult a plastic surgeon to see what would work best for you.
You can see from the other answers you can get help with insurance in California. Now you need to find a board certified plastic surgeon near you to get rid of that excess baggage
We send in photos of what you have and see what your insurance would cover. Sometimes they are unreasonable but it is definitely worth trying. I have a satellite office in SF and will be there again next month. I am Prsident of the American Society of Bariatric Surgeons and it is my specialty.
Dr. Edward Jonas Domanskis is Certified by the American Board of Plastic Surgery
Newport Beach, San Francisco,Miami, EU, Anguilla
Assistant Clinical Professor of SurgeryWOS-Plastic,University of California (Irvine)
Orange County’s Physician of Excellence/America’s Top Physicians/Top Doctors
Plastic Surgery
President,American Society of Bariatric Plastic Surgeons
Organoderm Skin care/ScaRxTape
Thank you for sharing your question. You would need to check with your specific insurance company, and policy, to see if and what surgeries they would cover for the loose skin, such as a panniculectomy. Many other procedures such as thight/breast/arm lifts are typically not covered expenses. Hope this helps.