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Insurance coverage!?

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Insurance coverage!?
« on: August 01, 2009, 02:46:18 PM »
Has anyone actually been able to have their insurance company cover their surgery fees? Personally, even though my boobies are tender I neglected to tell my doctor about it. I have seen a few therapists over the past few years related to issues with my gynecomastia. The surgeon I'm going with said one of his patients were actually able to have their insurance company cover their fees. So my mom, who's been very supportive, is trying to get the insurance company to cover me. Is this a complete waste of time? Just wanted to hear from you guys.


Linkback: https://www.gynecomastia.org/smf/index.php?topic=18608.0

Re: Insurance coverage!?
« Reply #1 on: August 01, 2009, 03:09:58 PM »
It's possible, and there are a handful of people on this forum that have, but it is VERY rare. Problem is they all see it as a cosmetic procedure. I think you may get at least a partial reimbursement if the breast is tender/painful, you have documented 'emotional pain' with therapists, and if you are otherwise skinny/low body fat EXCEPT for the gyno. If you are even slightly overweight, insurance will prolly see it as solely a dietary issue. Just be prepared to jump through a lot of loops.


Offline headheldhigh01

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Re: Insurance coverage!?
« Reply #2 on: August 01, 2009, 11:16:30 PM »
i don't think the docs would object to coverage, they'd welcome it, at least as far as they can deal with the paperwork. 

there was a new york case, i posted a link to the thread in the last month or two.  use the site search engine on keywords insurance, new york, ruling. 
* 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 Grandpa Bambu

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Re: Insurance coverage!?
« Reply #3 on: August 02, 2009, 01:32:59 PM »
Just be prepared to jump through a lot of loops.

Exactly dude...  From what I have read here over the years, going the insurance route is a major hassle... Many telephone calls, much paper work, being scrutinized by your Ins. carrier. And... after all that work... you could still be denied.

In that 'New York' case (if it's the one I'm thinking of...), the young man (in his teens I believe) put his private life, and very private condition (Gyne) on a pedestal for a court of law to dissect. Wow... that took some bawls to go public like that... The plaintiff won his case, but what a hassle just to get a $5000 surgery covered by health insurance...   :o

Surgery: February 16, 2005. - Toronto, Ontario Canada.
Surgeon: Dr. John Craig Fielding   M.D.   F.R.C.S. (C) (416.766.8890)
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