Medicare and Gynecomastia

[Denman]

Just wondering if anyone knows the latest on successfully getting Medicare to pay for surgery. Has anyone done this? And what doctors are out there who honor original Medicare, I have part N. One clinic I spoke to said they don't do any insurance, so I guess that includes Medicare. 

[42CSurprise!]

I can't answer that particular question but discussions about availability of insurance to remove breasts because they appear on a man's chest have always been told this is not a "medical issue."  I guess that means that being a man with breasts is not considering a health problem.  It may be a problem psychologically for men accustomed to seeing other men with flat chests.  I guess the corollary would be women who have flat chests who go to a plastic surgeon for implants.  That isn't covered by insurance either.  Adding or removing breasts is a matter of personal choice not medical necessity.  I expect the same it true with Medicare... unless there is cancer that would be addressed through a mastectomy.  Good luck sorting it out.

[Justagirl💃]

I'm on a Medicare advantage plan, and surgery has been suggested to be several times. The Psychiatrist is under the impression that "fitting in" would be beneficial to my psychiatric  health. Completely paid for under my current plan. 

I have declined every time, as I love my breasts and can't images life without them. 

My advantage plan is the PACE program. But that entails relinquishing most of your medical rights to the program.  A system that I will be leaving upon moving to Oregon. 

[WPW717]

Hell, I can’t even get Medicare docs to order guideline tests for MEN Syndrome, & when they do the radiologist or pharmacists put the kaibash on the order. That’s why I progressed to significant osteoporosis.

Starting over here in Tennessee in a different community.

[Justagirl💃]

Hell, I can’t even get Medicare docs to order guideline tests for MEN Syndrome, & when they do the radiologist or pharmacists put the kaibash on the order. That’s why I progressed to significant osteoporosis.

Starting over here in Tennessee in a different community.

MEN syndrome is a hidden infliction.  

The only reason why the PACE program offers the double mastectomy in my case is because I'm an embarrassment to them. They have a much bigger problem about it than I do. 

The other thing about the PACE program is your right to a second opinion goes away. Whatever the doctor decides goes, right or wrong.  

[gotgyne]

By the way: A man with breasts stays a man, as a woman after a bilateral mastectomy for cancer or the risk of cancer (BRCA genes) stays a woman. Thus why to remove them in men if there is no risk for health?

And moreover: Some young and many older men have visible breasts and don't care what other people think of it.

[WPW717]

Hidden affliction!, you got that right, Birdie. It’s even hidden from most doctors.

It started subtly in 1980. Then it progressed until it burst into a full blown health crisis in 2018. The resolution came finally after a series of surgeries that left me feeling less than happy and human. I handed them the MEN diagnosis and they ignored the possibility for a year.

In defense of health care the genetic testing wasn’t available in 1980 to hone in on this like it can be today.
But the syndrome was known about back then and there was a way to diagnose it.

Today it  is easy to do a genetic profile to assess whether or not the syndrome is present before it manifests into the problems that follow. If even one leg of the triad manifests then do the test. But the government & insurers have inserted themselves between doctors and patients all for the almighty dollar.

Now on Medicare I find they save money by denying patients the services they need until there is a harsh pushback and then it’s still an inadequate care, hence my osteoporosis manifested that was avoidable. 

Rant over, I am now in Tennessee & near a new healthcare system that shows a bit of promise to deal with this rare condition.
It’s lovely here and am enjoying my new digs.