Reconstructive procedures on the breasts, abdomen, back and lower back when you meet the following criteria established by SSS:
· Intractable skin infection documented by dermatologist.
· One year must have elapsed after bariatric surgery or loss of weight by another method.
· Weight must have been stable for at least 4 months before reconstructive surgery
· The tension and elasticity of the skin varies greatly, at least a loss of 70% of the total expected loss.
This should be calculated:
o Starting weight minus achieved weight, divided by starting weight minus weight ideal = > 70%
o The ideal weight is the one that corresponds to a BMI of 24 kg/m2 for that patient in particular.
· It is expected that in a tummy tuck they will remove four to six and a half pounds and in a breast reconstruction up to four and a half pounds.
· Hernia repair and abdominal diastasis recti repair are included in the price of abdominoplasties. If the plastic surgeon requests the intervention of another surgeon for the repair, the first will be responsible for the payment of this procedure to the other surgeon.
· All cases require prior authorization.
· The collection of deductibles or co-payments to the insured will not proceed.
· Surgical assistance will not be paid, nor can it be charged to the insured.
