Question for a Doctor/Anyone regarding my insurance coverage.

[Deadwood]

https://www.oxhp.com/secure/policy/surgical_treatment_gynecomastia.html

The above link explains insurance coverage for gynecomastia for Oxford that I found on the net. Im uncertain as to what would qualify for the following condition they state to approve coverage.

"A non self-induced pathologic condition that has been treated and has produced irreversible and functionally impairing symptomatic gynecomastia."

I have had the condition since puberty, well over 20 years.  I would imagine that would be considered irreversible. But funcitionally imapiring confuses me and Im assuming would preclude their paying. Does anyone have any experience with this matter?

Thank you in advance for any help anyone can provide on this matter.

[Deadwood]

Bump still hopeful for some advice

[GrandMstrBud]

My insurance looks similar.

http://www.wellmark.com/e_business/provider/medical_policies/policies/Mastectomy.htm

Policy:


Prior approval is recommended. Submit a prior approval now.
Mastectomy for gynecomastia may be considered medically necessary when all of the following conditions have been met:

Gynecomastia has persisted longer than three years as documented by the physician
The member has achieved Tanner Stage 5 (Full Sexual Maturity) and
The member has documented unilateral enlargement with questionable malignancy, or the presence of nipple discharge



Mastectomy for gynecomastia is considered not medically necessary under any of the following circumstances:
If the criteria listed above are not met
If the surgery is performed for psychological reasons
Breast enlargement resulting from obesity, or 
Breast enlargement resulting from medications