insurance and parents

[iamenfuego]

My parents said for the insurance that i should go to my regular doctor and have him look at it and refer us to someone i dunno why or anything but thats wat she said cuz thats how the insurance company works, we have aetna.  anything i should tell them? i feel like its just wasting time cuz i dont need to do that cuz i know the surgeon i will be goin to most likely writes a note to the insurance company to see if they will cover it or something like that. any opinions on this?

[Dr. Elliot Jacobs]

Unfortunately, it has been my experience that insurance will not cover surgery for gynecomastia (except in extremely rare circumstances).  They all have their own set of "guidelines" which they use to define whether the surgery is necessary and therefore should be covered. 

There is no harm in trying to obtain coverage.  I would suggest you contact your insurance company first and ask them what their "written" guidelines are as concerns coverage for gynecomastia surgery.  Then go to your doctor or surgeon and see if you qualify along those guidelines.  It may require certification letters from your surgeon, your endocrinologist and perhaps your shrink as well.  And there are no guarantees that even with all those letters in hand, that your insurance company may still deny you coverage.  One thing you can be sure of -- they will delay, delay, delay -- because they are not your friends!

Good luck!!

Elliot Jacobs, MD, FACS