According to my insurance, panniculectomy is covered, but my PCP won't ok it. It's depressing. I was in good shape before the surgeries. I look in the mirror and want to cry. There are both horizontal and vertical scars across my hanging abdomen. I explained to my pcp I don't want a tummy tuck, I need the excess skin removed. It Hurts, gets rashes. Sorry, but oes anyone do pro bono? Please help.
These are difficult situations. Consider finding a new PCP who may be more sympathetic to your situation.
You need to look at your policy to see what the coverage criteria are for panniculectomy. Some managed care plans punish the PCP monetarily when they refer to specialists, which could be why you are having difficulty. If your coverage criteria require a period of topical or oral antibiotic care prior to covering panniculectomy you can get around this by asking for a referral to a dermatologist. Once the dermatologist sees you and prescribes medication you will have the required documentation. Some plans require 3 or more months of nonsurgical care and a pannus that hangs over the pubic bone. Others require 2 episodes of infection treated by oral or intravenous antibiotics within a 12 month period. Once you have met the criteria if your PCP will still not make the referral ask to see a different PCP until you get the care you require. Good luck.