Will bcbs cover breast lift?

[gregorygirl]

While I was in the hospital on Monday no less! Ladies in there were telling me there is a way to code things to get tummy tucks and breast lifts if needed afterwards. I was amazed! ANyone know anything about this?

[Kimpossible318]

I don't know specifics, but I also have BCBS. I have heard that if the excess skin poses a threat - infection, etc, that insurance will cover. I'm not sure of the validity of that and/or what all constitutes the threat of infection. I plan on having a breast reduction done when I lose all my weight and since I have have documented back issues as a result of the boobage, I believe I can get that covered and then the lift will be done at the same time. I have lost over 100 lbs before and my bra size only went down one band size, so I have no doubt the reduction will still be necessary....just don't want to do it until I'm more....proportionate all the way around, lol.

[Rose69]

I have blue cross blue shield, one of their best plans and unfortunately they did not pay for my breast lift!

[azladyrider]

Years ago I played hell getting BCBS to cover reconstruction for valid medical reasons following a mastectomy so no they would consider this cosmetic for the breast lift. The reduction yes, since that is related to back issues most of the time as Kim stated.

[ltlsqueak]

Hope things work out for you. Hopefully your physician can help. Good luck and have a nice weekend!

[NancyN]

Don't know about just a lift, but if you need a reduction they might. I had one (two lol)done 21 years ago and they paid. Had documented history of upper back pain, dents from bra straps etc. And if there is overhang skin in the belly, and it gets rashy and yeast infection, it would be medical. So, start getting it documented that your boobs are killing you, and maybe you need to get some cream or powder or something for the skin. Documentation is everything.

[ThisIs4Me]

My surgeon also said that if u get rashes etc where ur excess skin rubs, ur ins might pay 4 the surgery to help clear ur skin probs up. Good luck

[MysticalMaybe]

I Know someone that fought their insurance company to pay and she won but they did a really bad job on her... I mean really bad. If you do fight for it and win make sure you see the doctors work and make sure thats what that doctor specializes in. She did the rash thing seen the doctor to get the rashes documented and that's how she won.

[MysticalMaybe]

I have kaiser and this is the link they gave me. Maybe your insurance has a website like this one.

Northern California Cosmetic Surgery - Kaiser Permanent

This has all sort of information and some have pics for you to see. I know alot of insurances will not pay for cosmetics unless you really need it but hay at least you would know your insurance companie has cosmetic surgents if you really need it!

[while.im.still.young]

I do know a woman who got her tummy tuck done through bc/bs. She says that the reason she was approved is because her procedure was submitted as a panniculectomy vs an abdominoplasty. Since I don't work for her insurance company, I can't be positive that that was the true reason she got approved but nonetheless, she got tucked. She also stated that both her and her surgeon were surprised by the insurance approval because she didn't have "that much" sagging belly skin.

[Debito]

I have a very rich bc/bs - has paid 100% of my sleeve. I received a letter stating they will not pay for any reconstructive surgery.

[Laura H]

Most insurances will not pay for anything cosmetic You have to have documentation that it is medically necessary. That is why they do not pay for upper arm skin reduction. There is no way it is not cosmetic. Procedures like a panniculectomy (tummy tuck) or breast surgery has to be medically necessary. Generally there has to be a large weight loss and keep it off for a certain amount of time and also a documented history of skin infections caused by the skin to skin contact. Those surgeries have to be pre approved through most insurance companies regardless of how they code it. You can call your insurance company and ask what their medical policy is for those types of surgery

[Bluetattoo]

I have BCBS Oklahoma. My surgeon is in Texas. He told me after i have met my goal weight and maintain it for 3 months that they would submit everything to my insurance to cover TT and Breast Lift. I've spoken with quite a few of his patients and they have confirmed that the insurance does cover it. But it's all about how the doctors office words the documents when they send them to the Insurance.

[Marvinator]

My wife got her lift approved but not the tuck. and we have blue cross blue shield.

[JustWantToBeHealthyAgain]

I talked to the bariatric office and they said that breasts lifts/reductions (lifts because of the excess skin) and removal of the excess skin on the belly will be covered by BCBS if I have 2 or more DOCUMENTED skin condition incidents. They told me if I develop a rash under the skin (which I get already, in both places) to go right to my doctor and have him document it in my chart so when I want to get the skin removed, I have a medical reason.