After a two hour appointment consisting of a million questions (I was armed and ready with a pretty long list), an evaluation (with me in my skivvies), and a photograph session (still in my skivvies...) my plastic surgeon is compiling a request for approval from my insurance company for my surgery. Even though the insurance company may cover the procedure (yes, there is still a possibility my insurance might not cover this) they need evidence in order to make a decision. The surgeon will submit a letter from his office and one from my primary care doctor explaining the medical need for the procedure along with the photos taken today. The downside of this is that the approval for the procedure is at the discretion of the insurance agent reviewing it and even though I meet all the criteria (most important one being that my skin hangs into my pubic region- yes, one day I will share pictures in case you are curious as to what that looks like) my insurance can still deny the claim. Even though I am healthy, have maintained this weight loss for almost 2 years, I am active, and take care of myself AND I have a legitimate need for this procedure- they can still say no. So that kind of sucks BUT I am staying optimistic. It will all work out as it should. Oh, and in case you are wondering it will take anywhere from two to six weeks to hear back from the insurance company. Ugh! More waiting.
Now as far as the procedure itself goes, I learned today that most insurance companies cover only what is called an abdominal panniculectomy which is for the area below the belly button. This is covered because there are medical issues (chafing, open sores, trouble urinating, even yeast infections) associated with having skin that hangs over the pubic region. The area above the belly button is considered cosmetic only and therefore not covered by most insurance companies. An abdominoplasty covers both regions. Both the panniculectomy and the abdominoplasty are made from the same incision and I can, in fact, have the panniculectomy (if approved) and the top half/abdominoplasty done at the same time. I would just have to pay out of pocket for the top part- which we got a quote for. Not cheap but doable. Pretty much what I thought it would cost.
My surgeon really emphasized the fact that if I have the lower half done but not the top half I will be really unhappy with how I look. And I agree. Especially after he showed me basically how much will be removed from my lower area, you know by pinching and pulling and poking. I also asked about lipo, a question a friend who underwent these types of procedures told me to ask, to which I was told that I don’t have anything to lipo out. That pretty much everything I see is just excess skin and when it is all removed and the underlying fascia is tightened I will see how very little fat I have in the area. That was crazy to hear but he told me to think about the fact that I lost a whole person’s worth of weight and how I shouldn’t be surprised that it left me with a whole person’s worth of extra skin.
I also asked about the timing of this all. As I mentioned previously about wanting to do this around Christmas since it would coincide with the university being closed. The surgeons there work through the holiday season, for the most part, and I was assured that even if it takes 6 weeks to hear back from the insurance company I would still be able to schedule it around the holiday. So that is really great news for me. Once we hear back from the insurance company I will be able to schedule the surgery that same day and the surgeon’s assistant told me she would do everything possible to get me in on or as close to the date I wanted. Yay!
I will definitely do another post where I write up all the questions, answers and discussion points from today’s appointment but for now I just wanted to get something out there so you all know what is going on. I will tell you this that the doctor told me (and Paul, who surprised me at the appointment) that I was a perfect candidate for the procedure and when asked what I needed to be doing to prepare for it, so I can have a successful outcome, he told me to just keep doing what I’m doing.
Please feel free to ask me any questions you want about this. I know that this surgery is pretty off topic for this blog but it is kind of a big deal and will be a big part of my life for a while- especially when I am immobile and there will be no running or riding. Lol!