Author Topic: Insurance for Endocrinologists??  (Read 2338 times)

Offline trojan213

  • Bronze Member
  • **
  • Posts: 77
Does insurance generally pay for appointments/tests @ the endocrinologist? I have pretty good insurance (BCBS PPO)...

Offline Paa_Paw

  • Senior Moderator
  • Senior Member
  • *****
  • Posts: 4779
With a PPO, you will probably need a referral from your primary care Dr.

With the referral, The Endocrinologist will be covered usually with a co-pay.

Without a referral, you are on your own.
Grandpa Dan

Offline moobius

  • Gold Member
  • ****
  • Posts: 426
don't count on it... insurance deems gynecomastia surgery as unecessary and cosmetic. i had my doc write up a case for me and submit to insurance to get them to cover it -- denied. i even found the exact guidelines they use to determine if they cover it or not and both my doc and I felt i met the criteria... went to appeal and denied again. i could probably fight them on it, but it'll cost me more in legal fees than to pay out-of-pocket for the procedure.  >:(

Offline Paa_Paw

  • Senior Moderator
  • Senior Member
  • *****
  • Posts: 4779
That is correct for a cosmetic surgeon, But the Endo should be covered at least partially with a referral.

Offline Grandpa Bambu

  • Senior Member
  • *****
  • Posts: 5444
  • 31 Year Gynecomastia Victim...
I could probably fight them on it, but it'll cost me more in legal fees than to pay out-of-pocket for the procedure.  >:(


Yup! They have us by the 'boys'....   ::)

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

Offline trojan213

  • Bronze Member
  • **
  • Posts: 77
With a PPO, you will probably need a referral from your primary care Dr.

With the referral, The Endocrinologist will be covered usually with a co-pay.

Without a referral, you are on your own.

Dang ... any idea how much basic evaluation might cost including lab fees/tests? The only reason why I want to see an endo before surgery is because I'm 24 and have barely any facial hair... Downstairs and armpits have been about a decade, but I never really developed anything on the face. I'm pretty lean besides the chest, so I'm wondering if I have a hormonal problem.






Offline Paa_Paw

  • Senior Moderator
  • Senior Member
  • *****
  • Posts: 4779
Check and see if you can self refer. If not, since you have BC/BS try to get a referral from your Primary care Dr. and go through the process.

My referrals to a Vascular Surgeon and a Cardiologist last year cost me $10 each. Without a referral they could have cost Hundreds.


 

SMFPacks CMS 1.0.3 © 2024