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What does it take for the insurance company to cover "gyne" surgery?

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Offline TM

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Im sure this has been brought up in the past, but I did a brief search and couldnt find anything. Im fully aware that they consider gynecomastia a cosmetic issue. I know all insurance companies are different and there are different types of policies with each company. My question is, what does it take to classify "gyne" as a medical condition??

Linkback: https://www.gynecomastia.org/smf/index.php?topic=11655.0

Re: What does it take for the insurance company to cover "gyne" surgery?
« Reply #1 on: September 11, 2007, 05:44:42 PM »
There are a few stories in here about people trying to get insurance to cover it.  I decided to save my money and just pay for it up front.

Some places have payment plans, offer financing, and most take credit cards too.  I don't reccommend using a credit card as a payment method becuase the credit card companies are out to get your hard-earned cash, but they are an option.


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Offline urbz

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Re: What does it take for the insurance company to cover "gyne" surgery?
« Reply #2 on: September 18, 2007, 09:34:08 PM »
I got insurance to cover my surgery.  I'm pretty sure it was the physical pain that did it.  And my surgeon knew how to submit it so it would give me a chance.  He said it was "the definition of reconstructive surgery."  I also had pain, to the point where it hurt to hug people and do things like run without compression.

Re: What does it take for the insurance company to cover "gyne" surgery?
« Reply #3 on: September 20, 2007, 12:09:12 AM »
I got insurance to cover my surgery.  I'm pretty sure it was the physical pain that did it.  And my surgeon knew how to submit it so it would give me a chance.  He said it was "the definition of reconstructive surgery."  I also had pain, to the point where it hurt to hug people and do things like run without compression.

Mine hurt when I run and workout but I still don't think I'll ever get insurance to cover it.

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Offline Paa_Paw

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Re: What does it take for the insurance company to cover "gyne" surgery?
« Reply #4 on: September 20, 2007, 04:41:16 AM »
It depends upon what kind of Insurance you have.

If there is pathology of the breast, which would be quite rare, most policies would cover it.

Demonstrable pain might be another. I would caution that it would not be wise to try and fake this as it would be very easy to get caught and you would then be guilty of filing a fraudulent claim and could get into major trouble.

If there is severe emotional problems, social isolation, etc. A Psychologist may be able to get coverage out of an insurance company that would not otherwise cover the surgery.

Some insurance companies specifically exclude any and all cosmetic surgery. Others might be more compliant depending on breast size and emotional impact.

Good Luck.
Grandpa Dan

Re: What does it take for the insurance company to cover "gyne" surgery?
« Reply #5 on: September 20, 2007, 08:33:33 AM »
It really takes the insurance companies willingness not to make more money. The try not cover as much as they can so they can keep more money and increase their profit. I think a lawsuit will probably change their mind by force. A class-action suit would probably do it.