Author Topic: Could insurance cover this?  (Read 2721 times)

Offline Desh

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Hey everybody,

I have had gynecomastia since puberty, and I am looking to get rid of it. Ever since I have had it, it has caused a lot of emotional/physical stress. I say physical stress because I attribute the gynecomastia to my atrial fibrillation, PVC's, and my flare ups of tachnycardia(all of these are heart related occurrences). I have heard people say that they will lie and tell their doctors that it hurts them. Though I am not partial to lying, I feel like it is important enough to my health to do whatever it takes to get rid of this. Can anyone give me any recommendations?
Extra Info:
I live in North Carolina. I am 20 years old, and I am with Blue Cross Blue Shields.

Thanks for all the input.

P.S. I understand that gynecomastia does not cause heart problems directly; however, I feel that the amount of stress I have endured has led to my heart problems.

Offline Dr. Elliot Jacobs

  • Elliot W. Jacobs, MD, FACS
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    • Gynecomastia Surgery
Insurance rarely covers surgery for gynecomastia.  You should inquire of your particular insurance company and find out about their criteria for qualifying for gynecomastia surgery.  It will, undoubtedly, require letters from various doctors, including mental health professionals to attest to the emotional problems you have.

From a purely medical perspective, it is highly doubtful that your emotional stress could lead to the heart dysrhythmias that you describe -- that is probably not going to help you in getting insurance coverage.

Good luck!

Dr Jacobs
Dr. Jacobs 
Certified: American Board of Plastic Surgery
Fellow: American College of Surgeons
Practice sub-specialty in Gynecomastia Surgery
4800 North Federal Highway
Boca Raton, Florida 33431
561  367 9101
Email:  dr.j@elliotjacobsmd.com
Website:  http://www.gynecomastiasurgery.com
Website:  http://www.gynecomastianewyork.c

Offline jojo82

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Hey everybody,

I have had gynecomastia since puberty, and I am looking to get rid of it. Ever since I have had it, it has caused a lot of emotional/physical stress. I say physical stress because I attribute the gynecomastia to my atrial fibrillation, PVC's, and my flare ups of tachnycardia(all of these are heart related occurrences). I have heard people say that they will lie and tell their doctors that it hurts them. Though I am not partial to lying, I feel like it is important enough to my health to do whatever it takes to get rid of this. Can anyone give me any recommendations?
Extra Info:
I live in North Carolina. I am 20 years old, and I am with Blue Cross Blue Shields.

Thanks for all the input.

P.S. I understand that gynecomastia does not cause heart problems directly; however, I feel that the amount of stress I have endured has led to my heart problems.

Insurance still considers gynecomastia a cosmetic issue and not a true medical condition. Until research can substantiate a link between male breast cancer and gynecomastia, it's unlikely that will change. Your only hope is to get a medical professional to conclusively link an emotional disorder with your gynecomastia.

Offline Rocky76

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What about the pain and discomfort aspects of Gynecomastia? IF it was a constant pain that interfered wit you r daily life and job. I would think that would qualify. Opinions?

Offline Dr. Elliot Jacobs

  • Elliot W. Jacobs, MD, FACS
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    • Gynecomastia Surgery
Insurance companies look for tangible, measurable reasons to approve a claim.  No one can measure an other person's pain -- there are no blood tests or x-rays, etc for pain.

One of the possible ways to go is with emotional distress -- but this has to be backed up by a letter of a mental health professional.  And no mental health professional is going to put himself on the line unless he has seen the patient many times in order to assess the depth and severity of the asserted mental anguish.  And even then, insurance approval is very problematic.

Dr Jacobs


 

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