Author Topic: Insurance is asking how gyno is limiting work function  (Read 1404 times)

Offline Snowblowjoe35

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Before my insurance will pay for my gyno surgery they want to know how my gyno limits my function. It's extremely painful and sore around my nipples. Obviously it affects me personally. I'm not able to sleep lying face down because of the pain. It affects me socially I'm not able to play sports without pain or modifying my movements. I think they only cover it if it effects work. It effects my work because of just always having to make sure I don't use that area. 

Any other suggestions on what I can day for insurance to cover. Suggestions on how it limits my work functions? 

Offline Paa_Paw

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Your Insurance company does not generally cover surgery for Gynecomastia.  But if there is pathology, they would cover the surgery.   It seems that you have applied for coverage based on the assertion that the condition hampers your ability to work.   Their response seems to be that they want to see evidence that supports your claim.
Pain such as you have mentioned is not common.  The usual problems with Gynecomastia are Psychological and/or emotional, not so much physical.  
Since you have claimed that Gynecomastia interferes with your ability to work,  they want to see something to support that.  I hate to say this, but the burden of proof is on you. 
Gynecomatia is sometimes covered by insurance, but usually only by the most expensive of policies. and usually only after a long waiting period.
Grandpa Dan


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