Author Topic: How to get the Surgery with a reluctant Insurance company.  (Read 331 times)

Offline Paa_Paw

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Sometimes the most direct route is not the best.
I am a Hiker.  There are times when a trail runs straight up and over a mountain, but there are times when the best route has a lot of switch backs and other times when the trail simply goes around the mountain. Perhaps tha will make a good analogy for any seeking surgery and facing a refusal from the medical insurance.
Years ago, we heard from the mother of a young man who was turned down for surgery because in their belief the surgery was purely elective and cosmetic so they would not cover the cost.  The young man was having problems with diminished sense of self worth and depression.  Going to the Family Doctor for Depression was covered.  When the Primary Care Doctor referred the lad to a psychologist, that also was covered.  The Psychologist then referred the lad for surgery stating that the Depression and diminished sense of self worth were directly caused by the Gynecomastia and that surgery was the only effective way to treat the young man.  Eventually the insurance company relented and the surgery was covered.
Sometimes, you need to go the long way around to get what you want.  Just food for thought. 

Grandpa Dan


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