Author Topic: Best bet for insurance to cover it?  (Read 3919 times)

Offline micheal

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Okay.

Im 17 yrs old, and ive had gyne since about 12. I want to try to salvage whatever i can of my youth. For a good part of these years, i have never gone in pools...to the beach and am embarrssed to be seen topless. The gyne has only grown bigger. I wish i had 6k to shell out on this surgery i really do. I tell my mom constantly, and i dont know she says shell call a doctor, but never does. If insurance doesnt cover it, i dont think she will pay for it. Honestly if this didnt attack me, and drive me insane mentally i wouldnt even care. Its stopped me from living a normal life like most people, and its something that was brought upon me, i didnt make it happen. I tend to avoid wearing clothes that i really like because my gyne protrudes right through out. I tend to wear dark clothing, that is baggy. When id really prefer colors and tight clothes. Im 5'8 175 lbs, broud muscular build. I know that my gyne isnt fatty gyne. It is most indefinatley Gland. Can anyone here help me out of what to say to the insurance company? I mean i have read that people have gotten them to pay for it. I guess its the way you go about approaching. I heard if you say 'bilatteral breast disorder' instead of gyne, it tends to go through better. I live in new york, so anyone surgeons that would help me to get insurance to pay?
Im reaching out to all of you guys, because your the only ones that understand.

:-/

Linkback: https://www.gynecomastia.org/forum/index.php?topic=234.0

Offline vaio

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  • Gyne free, is the way to be!
Tell the Doctor it causes you anxiety and depression.
$2,800 = Freedom!

http://pg.photos.yahoo.com/ph/vaiomanfree/album?.dir=7e36&.src=ph&am p;store=&prodid=&.done=http%3a//pg.photos.yahoo.com/ph/vaiomanfree/my_photos

Offline Bluesun_Returns

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Yeah, I understand and am a New Yorker too but I don't know of any other way to get the surgery other than to kick-out the cash for it.  As far as I know, there's no insurance-coverage for it in this area.  That's why I have to bight the bullet and finally deal with all the humiliation while going to work everyday with this condition so as I can scrimp and save for the operation.

As for telling your doctor about the stress on your mental state, I really don't know what in the world that would do.

Bluesun

Offline headheldhigh01

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wasn't new york the place that had that judge rule a company had to cover this?  use the site search engine, this was in the last 1-3 months.  
* a man is more than a body will ever tell
* if it screws up your life the same, is there really any such thing as "mild" gyne?

Offline wasatchm

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it might be a better bet to see a general surgeon who performs the male breast reduction surgery and ask him about insurance coverage.  whether or not you feel comfortable with him doing the surgery is another matter.  possibly even see if you can have him file the claim and get it approved for you.  anytime you have a plastic surgeon file a claim I think a lot of insurance companies have "cosmetic", "not really necessary" floating around in there head.  

I visited a general surgeon last week (who is also employed by my insurer) and he said insurance would most likely cover my surgery (I was shocked) (although I won't believe it until I actually here it from the insurance company myself).  he also said the gland really SHOULD BE removed (not sure why he said that) which made me feel good (coming from a surgeon who doesn't specialize in this type of surgery).  I think I will have it done with or without insurance coverage as soon as I get my hormones checked out by an endocrinologist.


Offline headheldhigh01

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you know, that's kind of an interesting observation.  it makes you wonder if they might not be looking to the stat that half or whatever it was of men who got breast cancer, few as they may be numerically, had gyne, and that the companies were thinking prevention could be cheaper.  (i always argued it'd be cheaper to cover it than a lifetime of depression and all its associated risks.)  

seems unlikely, but you still have to wonder.  

Offline wasatchm

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what I'd like to know is if most insurance companies  list male breast reduction surgery in the "TERMS OF COVERAGE" booklet they give out to all members.  I've looked through mine and don't see  any reference anywhere to male breast reduction surgery or gynecomastia.  the closest I could find was "mastectomy".  they appear to be referring to mastectomy for women when they mention it.   at first I though it would be a big negative (when an insurer does not mention male breast reduction surgery in there terms of coverage) now I am not sure.

is there anyone else out there whose insurance company addresses male breast reduction/gyne surgery in there "TERMS OF COVERAGE"? I am guessing that if supposedly 30% of all men get some gyne at some point in there life an insurer will NEVER say they will cover it IN WRITING!  they will either say , no we will not cover it, or they will not mention it at all (leaving it as a gray area).


 

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