Did insurance pay for your PWS treatment?

[mommy23]

Hi All,

I have a PWS on my leg and anticipate hearing from my insurance co that it just cosmetic and that they will not pay for treatment. Seems like PWS on the face are covered, but since mine is located elsewhere, I will probably be in for a fight. Anybody have any experience with this situation? Any help would be appreciated.

[hankbartenbach]

Hi,

Welcome to the group.

I am 23 year old with faical PWS.

I have been doing laser treatment for a little over 18 years now. I have been able to get the insurance to cover my laser treatments but not my debulking plastic surgeries so far.

I would suggest having the doctor you are going to see write a letter explaining why you need this treatment and why it is not considered cosmetic treatment.(Because PWS is a lifetime condition until technology gets better.) Tell them if they do not treat it now it will get worse and cost more in the future. Send them pictures and if you want you can use some of my pictures on my website (www.hankspws.com) to show them what happens if not treat properly.

Hope this helps.

Hank

[mastonmaltese17]

Hey,
My name is Melissa and I have a PWS covering my right arm, back and chest. My insurance pays for my laser treatments because laser is a necessity. Most PWS are caused my malformed blood vessels. The blood vessels do not close properly which causes increased blood flow...leading to the discoloration of the PWS. If this condition is not corrected it could cause the blood to create pools in the veins, which would lead to skin malformations. Laser surgery destroys the malformed blood vessels and creates new, normal blood vessels. I'm not sure where you're located but Dr. Louis Argenta is my plastic surgeon here in North Carolina (U.S.). He is the chief and director of the plastic surgery department at Wake Forest Baptist Medical Center. He is one of the best plastic surgeons on the East coast. He could help you! I highly recommend him or one of his colleagues.
My insurance would not pay for the "cosmetic surgery" I had to receive due to my PWS. My PWS covers my right breast, which made it two cup sizes larger than my left. At the age of fifteen I had to have a breast implant in my left breast. The insurance said that this was a cosmetic procedure and my family had to pay for the surgery. Luckily doctor Argenta worked with us and helped out our financial situation. My insurance still denies that this surgery was necessary...but I guess since they weren't the ones having trouble fitting in to bras and bathing suits, they wouldn't know!
Please contact me if you need any help or information! :)