Has anyone gotten BCBS of Texas to pay for panniculectomy?

I am interested in having the panniculectomy in the next 5 months. I have lost 123lbs in a year and the skin is bothering me. I am interested to hear the experiences of others dealing with the insurance.

I have BCBS of MI. I am posting so that I know how to go about getting approved after I lose these last 27lbs!

I'm working with my surgeon currently to get BC/BS FEP to cover the cost of my Panniculectomy. Are you planning on using the surgeon who did your WLS to do your Panni? When I went for my most recent visit with Dr. Turnquest (my surgeon), I chatted with a patient in the waiting room who had him do it for her awhile back and she's pleased as punch with hers! She looked terrific! Her stomach was FLAT! It helped that this patient was approx my age, build, and weight. I was initially hesitant...thinking "he's a WLS surgeon; not a plastic surgeon" but this lady was soooo tickled with her results (he even gave her a new belly button!) that I began pursuing it as soon as I got in the room with him. I have not lost all the weight I plan to but am within 20-30 lbs of goal and will be thrilled to have this apron GONE!!!! I have all the results associated with it: back pain as well as skin irritation and breakdown as well as odor - all from perspiration in that area.

I asked my long-term PCP to provide a letter stating all the problems I have with it. I've gotten a rejection already but the insurance girl in his office said it's not a "no"; they just need more information (ie: pictures) to prove medical necessity. Here's hoping!

I also have BC/BS of MI and will be interested in what transpires for others. The thing is, although I have lost 100lb so far, I am not quite ready for plastic surgery. And the other thing, I probably won't get all those skin irritations that everyone talks about because I have been getting them for years and I know how to treat them. So, am I going to have to let myself get a really nasty yeast infection, then take photos so I can get at least some of my surgery paid for? That is just depressing. But, summer is yet to come so we will see if I end up with these problems soon enough. Plus, I feel like I need what they call a total body lift. I imagine that is even more expensive. Would LOVE to have the arms done now. Good luck everyone!

I have no problem with my weight loss surgeon doing the surgery. I did read on BCBS site that you need to be 18 months post op. Keep me informed on your progress.

UPDATE: I have BC/BS FEP (Federal Employees Program). The drs office sent pictures they took of me to the insurance co. THREE TIMES!...but BC/BS said they didn't get them. Last Wednesday, the drrs office called to tell me they were going to submit once again but that the insurance co usually hops if the insured calls to help it along. I did and was given an alternative address to which they could send the pictures (one that has a lighter volume of mail). I called this am and was given verbal approval. I'm in!!!!!! They will be calling me hopefully tomorrow to schedule it. Now, I just have to plan around my high school reunion (in April) and my husband's high school reunion (end of June). Decisions, decisions!!!!

Congrats to you efh56!! What a wonderful dilemma to have ;-)

Hello, I work for VA, here in houston thinking about switching to BCBS federal, did they pay for you pannilectomy? what is a difficult process? what was criteria to be met?