Author Topic: Can I get BlueCross BlueShield to cover my case?  (Read 3488 times)

Offline nukem2k5

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  • Posts: 533
  • Breasts belong on women!
Here's a link to the thread with my pictures:

http://www.gynecomastia.org/cgi-bin/gyne_yabb/YaBB.cgi?board=11;action=display;num=1111344819

I can afford the surgery, but I'd definitely prefer to have insurance cover the excision.  Has anybody had any luck with BlueCross BlueShield?  I can say that they hurt me, but are the chances of that working very high at all?

I haven't had my consultation yet; it's scheduled for May 25th...too long D:

Reborn on May 24, 2005
Surgery Cost: $4,040
Dr. David Metzner - New Orleans, LA
My Photos
Two Years Post-Op Photos

Offline BigApple

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  • Posts: 18
Check this out:

New York Daily News - http://www.nydailynews.com
 
Hit insurer for teen's breast op  
BY HELEN PETERSON  
DAILY NEWS STAFF WRITER  
Wednesday, December 1st, 2004  

Breast reduction surgery for an 18-year-old man wasn't just cosmetic, it was a medical necessity, a Manhattan judge ruled.  

The decision came in a lawsuit filed by the Long Island teenager's father, who sued his health insurer, GHI, for refusing to pay for the surgery.  

Small Claims Court Judge Barbara Jaffe said the teen, who suffers from a hormonal imbalance, was robbed of a normal life by his condition.  

"In order to avoid the great embarrassment and suffering he endured when ridiculed by his peers, [the teen] never swam, went to the beach or engaged in any activities which exposed his chest to view," Jaffe wrote in her decision, made public yesterday.  

The teen's father, whose name is being withheld by the Daily News, represented himself in the case, even though he's not a lawyer. "We just felt that this was a case that should be heard and I was not going to give up," he said.  

GHI argued that the surgery was cosmetic and elective and not covered by insurance. The insurance giant said it will appeal.  

The dad said his son had the $7,500 surgery in July and was thrilled with the results.  

"The kid's emotional state went from zero to 100. It was a tremendous attitude change for him," the teen's father told The News. "If it cost me $100,000, I would have done it."  

He said his son's condition, known as bilateral gynecomastia, was caused by a hormone imbalance.  

After his claim was rejected, he filed a $5,000 lawsuit in Small Claims Court, and presented a case, including affidavits from doctors who said the teen's breasts were "inhibiting his psychosocial development."  


 

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