Gynecomastia Support Forum

General => Your Stories => Topic started by: thatkoolkatal on June 18, 2007, 08:53:38 PM

Title: Insurance
Post by: thatkoolkatal on June 18, 2007, 08:53:38 PM
Can anyone tell me if their insurance paid for the Gyne surgery?  I have my initial consultation on July 16th.  My medical insurance will cover 80 percent of the op if it's deemed medical and not cosmetic.  Isn't Gyne a medical condition?  The receptionist told me she's seen a 50-50 split over acceptance-my insurer says there is no prior authorization required, so that means I could have the surgery but then be stuck with the bill.

Any feedback would be much appreciated. 
Title: Re: Insurance
Post by: Jugs on June 18, 2007, 09:16:54 PM
my insurance covered it, but that was 12 years ago. The doctor reported the surgery as a biopsy. Good luck.

Capulet
Title: Re: Insurance
Post by: thatkoolkatal on June 18, 2007, 09:36:52 PM
Thanks Cap, I've got my fingers crossed. 
Title: Re: Insurance
Post by: newmanby30 on June 19, 2007, 10:15:46 AM
I have just recently tried to get mine covered by BUPA in the UK, but they see it as cosmetic treatment, not medical - they say it is "unnecessary removal of healthy tissue" which is why they won't pay.

Little do they know
:(

Hope you have better luck

Newman
Title: Re: Insurance
Post by: thatkoolkatal on June 19, 2007, 10:41:11 AM
I'm sorry to hear that Newman.  I'm going to get it done either way, if I have to pay for it myself.  Insurance companies are not our friends.  Did you get it done anyway? 
Title: Re: Insurance
Post by: Deadwood on July 03, 2007, 11:37:11 PM
My Oxford policy will cover it because of an underlying pathologic condition (or so IM being told).

They have several dozen plastic surgeons in the area, but now I have to figure out some way to judge the relative merits and decide on one. IM trying to keep it to someone who will accept their insurance because even after  this I will have to spend a lot more on corrective dental work for the same problem.

Good luck to you.
Title: Re: Insurance
Post by: thatkoolkatal on July 04, 2007, 10:59:10 AM
Thanks Deadwood.  I just had my consultation yesterday.  It was mortifying but rewarding as well. I'm going to have the surgery whether insurance pays for it or not.  My Doctor told me he's going to contact my primary care physician, the more the merrier, to try to get my insruance to cover it.  Prior authorization is not required, so it's a total crapshoot.  I'll probably have to wait 2-4 weeks before I know.

Once and for all, I have to get this done.  I'll let you know what happens.  Thanks for the support. 
Title: Re: Insurance
Post by: chachkid on July 04, 2007, 01:07:48 PM
my insurance covered the whole operation.Its all on how the doc words it in his discription.Make sure to tell him that it is causing you a great deal of pain and it is affecting your overall health.Also tell him that breast cancer runs in your family and you want the tissue tested.thats what i said and i got approved 100% but it also matters what kind of insurance you have

good luck if you have any ?S  just ask
michael
Title: Re: Insurance
Post by: thatkoolkatal on July 04, 2007, 01:20:57 PM
That's what I did Mike.  I told the PS about how it hurts after a workout, and sometimes I feel this bumping, thumping pain.  He's going to do his best to get my insurance to cover it...he's also going to consult with my primary care physician. 

Now all I can do is wait and see.  I appreciate the support.  I will let you know what happens.  I want to support others going thru this, we need to help one another.  Only we understand the torment of this condition. 
Title: Re: Insurance
Post by: chachkid on July 05, 2007, 12:54:25 PM
well keep me posted i hope insurance will cover it. If not are you still going though the surgery on your own,even if my ins. didnt cover it i was going to get it done any way. Im 2 weeks post op today and i feel like a new man,tomorrow i get my stitches removed and in another week i can hit the gym again.

well best of luck with everything
mike
Title: Re: Insurance
Post by: thatkoolkatal on July 05, 2007, 01:22:07 PM
Yes chach, I'm getting it done either way.  All of my goals in terms of self esteem, physical and mental goals are being blocked by this horrid condition.  Now that I know what I know about Gyne, going to the gym feels like a waste of time for me.  I can't wait until I get it done!

Tell me, how much did it hurt?  Did you have to take off time from work? 
Title: Re: Insurance
Post by: chachkid on July 05, 2007, 10:26:19 PM
The surgery it self was easy and so is the recovery,the only thing that hurt like hell was when the doc removed the drian tubes three days later(like someone stabbing you)but maybe you wont need them.I had to take three weeks off from work because my job is a physical one(firefighter)but if i had an office job i would have been back in less than a week.right now i feel great and i go back to work on sunday and then i can hit the gym by the end of the week.The swelling has stopped and i can get a good look  at what im going to look like Im so happy i should have done it 7 years ago.
your going to love it let me know how things go
best of luck
chach
Title: Re: Insurance
Post by: normexcept on July 18, 2007, 02:58:14 PM
Keep us up to date on the progress of finding out about insurance paying for it.  I'm right behind you as my initial consultation is Monday July 23rd.  I'm going to try to get insurance to pay as well.  My wife had a breast reduction surgery through this plastic surgeon and had all hers paid for by insurance.  They said that they work to accomplish that task if it is possible.  I'm with you though.  I'm going to get the surgery either way.  I can't wait to be rid of this burden.

Good luck!
Title: Re: Insurance
Post by: thatkoolkatal on July 18, 2007, 03:26:38 PM
Thanks Norm!  My PS sent me the letter he sent to my insurance company, and he did his best to write it in such a way as to persuade my insurer to cover the cost.  He included some of the medical issues I'm having with the Gyne as well as pictures.

All I do now is wait!  It's excruciating, but trust me, once you have your first consultation, you will become determined to get the procedure done either way.  The pyschological lift you will feel from being able to discuss this horrible condition with your PS, and the knowledge that there is hope is the first step. 

I will let you know what happens.  Good luck on the 23rd-it will be the first day of a new life. 
Title: Re: Insurance
Post by: thatkoolkatal on July 20, 2007, 05:52:54 PM
My insurer turned me down.  Said the sugery is cosmetic.  I wasn't expecting it to be covered, so now I'm moving on to the next step-I'm getting the surgery!  To me, this is like running down a steep hill...there's no running back up.

I'm now checking out pricing and financing options >:( :-\ :-*
Title: Re: Insurance
Post by: matthew1 on July 20, 2007, 06:14:07 PM
  I am going to  have to disagree  with  you guys. As  horrible and  depressing as  this condition can  be to  our  emotional health etc, I  do not think  MEDICAL insurance  should  pay for it. Where do   we draw the line,  breast enhancement on women?  eyelifts,  chin lifts  etc...... there are arguments to  support all of these  operations , they are all equally  hard on the  person with the particular problem. My gyne is no  more serious  then a  young  girl with lop sided breasts.
        My insurance premium is  $1,080  a month now , and  thats a deal  after I did  some  manuvers to get a lower rate. If insurance companies have to cover  elective surgery , premiums will only rise.
          Nothing is free.........
                               
Title: Re: Insurance
Post by: Don Won I on July 20, 2007, 09:46:31 PM
Quote
I am going to  have to disagree  with  you guys. As  horrible and  depressing as  this condition can  be to  our  emotional health etc, I  do not think  MEDICAL insurance  should  pay for it. Where do   we draw the line,  breast enhancement on women?  eyelifts,  chin lifts  etc......

What?

Insurance should cover it because last time I checked, men aren't supposed to have breasts. If someone has gynecomastia due to puberty or some freak accident, then it should be the insurance company's job to take care of it. People who have caused it with steroids, marijuana, or etc. should be tough out of luck.

Comparing gynecomastia to implants, eye-lifts, and chin-lifts is a stretch. Those are obviously procedures which are 100% cosmetic. A 14 year old boy with a B cup size shouldn't have to suffer because his insurance company is ignorant to what gynecomastia is and how it affects someone. It is a medical condition unlike having droopy eyes for an eyelift. I'm sorry, but gynecomastia should be labeled as reconstructive surgery. Like I said before, men with breasts = not natural. I'm sure 9/10 doctors would agree.
Title: Re: Insurance
Post by: thatkoolkatal on July 20, 2007, 09:58:35 PM
I could not agree more.  Luckily for me I have the financial means to go ahead with the procedure-I really feel for those who suffer with this condition who do not have those means.  It's a horrible, horrible condition that wreaks total havoc on the pysche of those who suffer from it.

If I ever become rich, I'm going to start a fund for those who suffer from this so they can have the surgery.

For me, the road has just begun. 
Title: Re: Insurance
Post by: normexcept on July 28, 2007, 06:11:50 PM
I was given a pamphlet on financing surgeries.  I didn't know that was even an option when I posted to this thread earlier.  I thought insurance was the only way I was going to be able to afford to pay for surgery but the pamphlet I got from the plastic surgeon makes it sound doable with what I earn in wages if I plan around it.  It sure gives me hope that this is really going to happen now.
Title: Re: Insurance
Post by: normexcept on July 28, 2007, 06:13:08 PM
You know Kool,  the foundation idea has gone through my mind as well.
Maybe someday..................................
Title: Re: Insurance
Post by: thatkoolkatal on July 28, 2007, 06:42:12 PM
Norm, can you tell me where I can get such a pamphlet?
Title: Re: Insurance
Post by: normexcept on July 30, 2007, 09:47:14 PM
I got the pamphlet from the plastic  surgeon's office.  There is a web address on the pamphlet though.
capitalonehealthcarefinance.com (http://capitalonehealthcarefinance.com)
Norm
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