A facelift, Vickie Stevens said, would be one thing. Same with breast implants and wrinkle injections, which she sees as procedures that help people to look better, not necessarily live better.
But Stevens is just trying to live, she said, and enjoy the results of her efforts, through dieting and gastric bypass surgery, to lose nearly 300 pounds.
“For the last two years I’ve been working my butt off, trying to get as much weight off as I could, thinking ‘Oh, no problem, I’ll be able to take care of this after two years,’” the 45-year-old said in her Groton apartment building.
“This” is skin — approximately 30 pounds of it on her arms, back and stomach, she says — that serves as an unwelcome reminder of the weight she has lost and a roadblock to being able to enjoy it.
Stevens has health insurance through HUSKY Health care, the Connecticut program that administers Medicaid.
Medicaid covers weight loss surgery when a person’s obesity is causing a secondary medical condition, such as hypertension or joint aches, according to David Dearborn, a spokesman for the state Department of Social Services.
Stevens qualified for Medicaid coverage of the surgery more than two years ago, when she weighed close to 500 pounds. She ticked off the medications she was taking at the time for secondary medical conditions: drugs for high cholesterol, drugs for high blood pressure, insulin for the Type 2 diabetes she had for six years.
After a false start — her sister’s bad experience with gastric bypass spooked her out of a scheduled surgery in 2014 — Stevens went through with it, losing 50 pounds before even going into the operating room and losing an additional 200 pounds after the surgery.
A surgeon at Middlesex Hospital completed the procedure, making her stomach smaller so Stevens now she feels full quicker. She went on a strict diet, and has started going on walks.
Two years later, she’s no longer diabetic. She can get in her car, stand up for more than a few minutes, go on walks. When her father had triple-bypass heart surgery in 2015, she temporarily moved in with her parents to help him recover, something she says she never could have done before.
But she’s been left with the skin, which hangs off her arms, back and stomach. The skin on her stomach, which stretched when she was at her biggest, now impedes her walking, causes sores and stops her from truly being able to enjoy the weight she’s lost.
And when she recently set about trying to get it removed in a procedure called a panniculectomy — similar to a tummy tuck — she was surprised to find that Medicaid wouldn’t cover it.
A federal rule prevents Medicaid plans from covering cosmetic procedures, unless a patient can demonstrate a medical need, Dearborn said.
Local plastic surgeons have either declined to rule that the surgery is medically necessary, or have stopped returning her calls, Stevens said.
