UPDATE

[nothingworse]

Well, I posted before a while back about trying to get Aetna to cover my medical case of gyne. Well, I got denied on Tuesday of this week. So, we were done playing their games. My mom called them and explained to her on the phone for 2 hours (for real) and what this has done and why we have to have coverage for this. They didn't even look at my pics I guess and just sent me a denial automatically. My mom asked who did this and why. So she faxed a detailed history of my problems with this with all doctor documentations and what this has done to me. So, I wait another 2 weeks maximum for my approval. They are finished pulling their crap and have no way out anymore because I have backed up proof from the specialist and my GP that goes back almost 3 years. We faxed a story about my gyne and everything it has caused and we will wait out this 2 week period for our approval. My mom threatened them already and the supervisor is sick of having these chats with her. My mom and the supervisor have talked for a total of 15 hours on my case. We are pissed as hell with this. So, I will get coverage this time or it is the last straw. My father has already contacted the public news to do a story and threatened employer action to Aetna. We are tired of the whole scenario. Anyone trying to get coverage from Aetna that doesn't have a medical case of gyne is wasting their time. They automatically send denials out. We have fought them for so long and I actually have a problem. This is and I will garuantee the last time we appeal and wait. They just didn't understand and now I think the supervisor understands the problem. My mom told them she doesn't care how they do it she just wants them to remove or rid the glands. We just want this done and it will be done. They have no possible escape at all know so they have to say yes or they are really going in for it. This just took to long fighting with them. And considering it the time wasted equaled a lot of money. God help those foolish insurance companies.

[nothingworse]

Oh,

And one of my moms friends has Aetna and grew some slightly cancerous growths on her face and had them removed for $1200. She thought Aetna would pay and guess what they didn't. You ask me how they won't pay for cancer. They won't pay for nothing. They are the crappiest insurance company in the U.S. They have stooped to the lowest levels of any insurance company. And to tell you the truth some of the things they are doing are almost illegal. As the economy gets worse insurance does as well. I was informed by a few specialists that back before 2000 or before George Bush got in and started making foolish changes most insurance companies would even cover non-medical cases of gyne. Now I am having a serious problem just trying to get my medical case covered. Wow, how times change. I am pissed about that cancer thing with that woman as well. She is very sick and has had many operations and is on many pills. I have seen her and she is like walking death. These insurance companies are killing people and they don't give a *uck. The only actual surgeries most are now considering are heart and bad cancer realated which makes the profit of the insurance companies larger and more powerful than before. It is disgusting and corporate America is getting disgusting. The economy is getting better my a** it is getting worse as the days go by. $14 an hour jobs are slowly going to $10 an hour jobs than those are going to $7 and what else not. More jobs a lot lower wage. Great economy isn't it?

[Gine2D]

Removal of male breasts because of gynecomastia is not a medical procedure, it is a cosmetic procedure.  That is why the insurance will not pay for it.

Men do not die or have serious physical problems forom having breasts.  Millions of us have them & get along very well.

Insurance do not pay for breast enhancment or face lifts.

[nothingworse]

I have physical pain from my breasts (NOT FROM GROWING PAINS). My GP said best thing to do would be Excision. I only have a mild case of gyne that is gland. And it is sensitive and painful and throbs. No joke. I am not getting it for cosmetic purposes. I saw my GP for 3 years straight because of repeated problems. It is not from growth. I am just reporting what happened. And yes insurance is going to cover it because I am qualified physically and have all the info needed from my GP visits and specialists from repeated problems. I went over this before.

[brama]

What will ya do if your insurance just wont cover your surgery?

[nothingworse]

Brama,

My parents and I have taken action like 12 times with this bs. They are just a pain in the a**. We have talked to the supervisor multiple times for a total of over 15 hours. She is sick of us fighting and has given up. This shouldn't be a battle but, they make it that way. Right now insurance companies are not covering much. They are almost commiting illegal acts. They are not even covering certain cancers which is rediculous. The only surgery you will get granted right away with Aetna is a heart surgery. By concerning only those with heart or a major life threatning surgery they will save a lot of money and multiply there profit over and over again. And the executives will give themselves nice million dollar bonuses. And yes that stuff does happen all the time. Corporate greed. So then they are fighting and being an a** on pain and suffering. I experience pain from it and it stated under there contract pain is covered. I am looking for the solution. My father fought once before because of a personal family memebers problem with insurance and it was on Channel 6 news. We don't want to go that extra step but, are doing what we can to avoid it. I am not joking. My chest hurts like heck whenever I lift and put any pressure on it or strain. The chest is the males strongest body part. It is kind of a disablement. It affected my work performance at my old job loading and moving heavy boxes. I am just looking for a solution and the point is I don't care what they do because it is for the physical pain. I don't care what method they use to get the glands out I just want the pain relieved and the daily discomfort as well. I got my molars removed and they said take pain pills for that. I didn't need them and the surgery was painless for me. My chest hurts worse than that all day. I saw a doctor, he confirmed I have a problem, specialist as well, and the solution is rid the glands or remove them. Aetna can do that by spending $1500 lousy dollars for my procedure. They are a multi billion dollar company and that would be like a normal person losing a penny. They sent me a bs letter denying it the first time saying it is cosmetic. Mine is not cosmetic. They consider Liposuction cosmetic. I didn't ask for lipo I didn't ask for breast reduction. I asked for gland removal and we have explained to them 12 times it is not for a cosmetic reason and have doctor notes from 3 years of visits to pass to them. My mom asked if they even read my case and put thought into it. They just sent me the regular old denial letter. And no I am not like most stupid people on this planet who will say what if they don't cover it. There are many more ways than 1 to make them. They have after this last call we made today stood down and have finally broken. Which means now the chances are about 75% plus they will cover it. I get my letter back in 2 weeks and will see what they say. If not the game is up and no more playing around. We will take 2 courses of action and not send a letter back saying appeal it one more time. In fact most people on this board trying to get insurance coverage on this board sent an appeal letter back. Didn't they know you can fax it over and save a week plus worth of time. The actions we will take are going to my mothers employer. The company she works for provides Aetna with Multi Millions of dollars of business so they will threaten them because they have a lot more weight. My mom has already talked to mary her employer about my condition and problems and I know mary as well. So she understands. We can push the issue through her. Also, if we have to we will do a PS or a Public Statement throught the news and last time the old insurance my parents had didn't like that and quickly settled onto good terms. The point is if you have a problem you can fight the insurance company. Fighting isn't about writing letters back and forth. You don't solve anything that way. You have to fight and I mean with the damn supervisors of the company and battle time and again to win. Why should I or my parents have to pay for a problem I have. Everybody else in my family knows my problem and supports me and asks me why I can't get coverage? I said I don't know. They have messed around for months playing their games and I am really tired of it and this effing condition which bugs me because of the pain day in and out. It will never stop until I get the solution. I tried every dang thing I could naturally to do something nothing worked. And this makes me so sick some days even kids in school ask me what is wrong because my face shows painful expressions all day. I am tired of the whole ordeal. This isn't a game anymore. My mother made a letter up and recordings of days and has a letter made up of all my problems and what affects this has had on my life and some of the downfalls of this. The biggest part of the letter is in quotes "I wish I could wake up one day and feel normal again" My eyes have black rings under them I feel like crap everyday. Can't sleep at night because I don't want to roll over on my chest. I have to block myself in tight so I don't roll over on my chest. The pain you feel after you have gyne surgery in your chest area is what my chest feels like probably on a good day. I am sorry for the long post and all the stuff I added but, it is just so hard to explain. It is just rediculous. My parents tell me you have to fight for everything in life. I know what they mean. I had to fight to get my acne taken care of, fight for proper respect in school, now I have one last fight to win and that is to get my chest taken care of. We switched to Aetna about a year ago. They have only covered about $1000 worth of stuff for us like heart medicine and sleep machine costs. We have already spent nearly $6500 with them. They treat us like crap now. Besides this I am so pissed about what they did to my moms friend the one who has the cancer problems. Aetna and many other insurance companies need a straightening out session. They have to crack down on them sooner or later. They can't just keep doing this. They have to make profit but, they also have to be good to their costumers. They make billions but, have a hard time forking out millions sounds like they are raking in the bucks and effing us all over. They don't care if you die because they don't cover your $5000 procedure to remove some cancer. They just have hit level zero. And they definetely need to update their info. They just send the same crap with no correct facts and get away with it. The stuff they put on my denial letter didn't even make sense with what we asked for.

[Worrier]

'Nothing Worse' Iam no huge fan of a company that will not pay for an operation that will deal with your gyne.It must be horrendous having gyne at your  age and if it is causing you physical pain as well then I do not see why they will not cover it

However whether we agree or not Aetna have a limited budget and the way  the way see this is it will not kill you or make you seriously ill physically and to them it is cosmetic gland or not.The pain is academic to them. I know you have been fighting with them for a while now and is it not time to think of a nother way to fund this? I see your point your parents pay for this policy and out of principle they should do it but they may well not budge as this will open the floodgates. Yes you could go to the press but they have all sorts of clever lawyers and it may make the situation worse.
        you say it costs fifteen hundred dollars, can't your parents help you out? Iam just thinking you could be fighting this for quite a while and it is obviously causing you problems right now.Anyways I hope this gets sorted out in some way.

[gynosucks1]

you're not dieing from the gyno

and as far as the pain, even if you are expieriencing full out gyno pain it is no thing to actually be bitching about... fact is it's not all that painful, just sensations.

i agree that insurance companies should not have to pay for gyno.  it is in fact a cosmetic procedure.

[nothingworse]

Gynosucks1 I am looking to get this problem corrected. I am at the point now where I will wait about 2 weeks for my answer and if they don't approve it I will pay for it myself. I am not dieing from it but, the sensations and pain get old and it does hurt all day everyday so I want it taken care of. I think I am going to look into going to Jay Pensler in Chicago if I can't get this approved with insurance. I will get the money because my grandma said if insurance doesn't pan out she will borrow me 3 thousand. I have $1500 and my procedure would be a short one so that would easily cover it. I will of course pay her back within a year. That is basically it I only want this resolved it just gets sickening and I am going to do it asap.

[nothingworse]

I contacted Pensler and the total would be about $4600. One more week to wait from insurance though. And I actually think they are going to cover it because they just refunded my parents $250 for some tests and bloodworks. Stuff that was done about a year ago. Things are starting to look better with them. And while my mom was on the phone with them the supervisor typed up our story and is very understanding. We have a good chance of getting this approved if not I am going to Pensler. Either way this will be done in about another month. Afterwards it will be time to hit the weights a lot again and get back up into shape. About 6 weeks of resculpting will do great. It has just been so long and I am ready to jump to the other side. I went back to the doctor to get a confirmation about there being gland on the sides of my chest. He said there was a bit of fat but, a layer of gland as well on each side. He said that was unusual. Well, once the gland is gone and the puffy nips are down everything will be good.

[gynosucks1]

Gynosucks1 I am looking to get this problem corrected. I am at the point now where I will wait about 2 weeks for my answer and if they don't approve it I will pay for it myself. I am not dieing from it but, the sensations and pain get old and it does hurt all day everyday so I want it taken care of. I think I am going to look into going to Jay Pensler in Chicago if I can't get this approved with insurance. I will get the money because my grandma said if insurance doesn't pan out she will borrow me 3 thousand. I have $1500 and my procedure would be a short one so that would easily cover it. I will of course pay her back within a year. That is basically it I only want this resolved it just gets sickening and I am going to do it asap.

dude i understand ur pain

just bitching because about insurance company is what i disagree on .

insurance companies have a quota to make and they are a business.  they made these guidlelines in terms of gyno for a reason.

shit lol

almost every guy has some degree of gynoand if it were easy i see almost every guy going to have a boob job to get pecs like those guys from troy.

[nothingworse]

gynosucks1,

That would be great if I got the glands removed and I had pecs like the guys from troy. But, that isn't what I am aiming for but, don't get me wrong it would be great. But, anyways normal fair results are all I am looking for with the glands gone, the sensations and all that crap gone. And the bottom of my chest to be flat and swell back down and the nipples to go back down to size. I am just looking for average to normal. I am not looking for pecs of gold. But, I did work out my chest for a long time earlier in my life at an attemp to rid the crap but, there is a good amount of muscle underneath. So as long as the surgeon does a fair job and rids all the excess gland and the small amount of fat then my chest should look fine. And afterwards I can finally work it out again and tone it up. Also, raise the cardio up and get back into tip top shape. I keep myself in fair shape and I am at a pretty good weight and build for my size so just a little extra work and I can have all I need. Plus I can rejoin powerlifting second semester because I can then use my chest again to full capacity to lift more and better. Things should be back to normal and I should be feeling better. One more week to go for an answer and if not I will go to Pensler or get it done by a qualifed surgeon. Everything just depends.