Insurance Coverage Experiences

[needhelpnow]

Just wondering if anyone would contribute to this thread. I am interested to see what insurances companies people have had experience with. Also if you were denied coverage for surgery or what was covered. I am currently waiting on mine to rule on my case. I have seen some on the boards that will cover it some but most don't. Let me know what you guys have experienced and what insurance company. Good luck to all.

[Paa_Paw]

First of all, many people leave the site and do not return after a successful surgery so the people who could best answer your question are simply scarce.

Each different company writes several different policies with differing levels of coverage.

Some policies exclude coverage of any type of cosmetic surgery while another more costly plan from the same company may be more liberal in their coverage.

You will need to study through your policy first to see if it might be covered. Then see if they will cover the surgery. Even if it is refused initially, You can file an appeal. If your appeal contains a letter from a Psychologist or Psychiatrist clearly stating that the surgery is to treat a condition which is causing you great personal grief, anxieth, social withdrawall, etc. you have a greater chance of success.

Good Luck.

[infinity123]

I had Health Partners, and they amazed me, and several doctors, by covering the procedure and consultations. Gyn surgery is covered in their procedures list, but you need to meet certain criteria. As I recall, they were that the gyn was not caused by being overweight, that it did not seem like it could be treated in any way besides surgery, that it was fairly stable and wouldn't go away with time, and that it wasn't due to something like steroids. I had my primary physician diagnose me first and refer me to a surgeon. I think in the end, if your health insurance company will even possibly cover it, it's still a pretty gray area as to whether they'll cover it, and will come down to a judgment call by someone there. In my case I think it helped that the dr sent in pictures and that I had obvious unilateral gyn. If you get turned down, put in an appeal. --Best of luck