ways to make it medically necessary so that insurance covers it?

[tartan_tiger]

Well, I posted not too long ago about how in addition to having gyne, I also have hemophilia so the typical cost of the procedure is about 10 fold. Does anyone think that I could get the procedure deemed medically necessary by my psychiatrist/psychologist? It's pretty much ruined my life and I actually just got out of the hospital after a suicide attempt and I know that nothing is going to change in my life until I fix this problem that has been plaguing me for the past 7 years. It's such a massive quality of life problem and causes me severe psychological issues I just don't see how it can't be considered medically necessary. At this point, it really is a life or death issue.

[Jake]

It could go two ways:  First way, you tell some insurance board that the condition literally made you attempt suicide which landed you in the hospital.  They suggest mental help.  Second way, you do the same as before but they agree to cover the surgery.

I honestly don't know what they would do.  They might agree to cover it, but you never know.

If it's causing you this much distress, I would be getting an appointment lined up with some insurance rep. or something.  If it IS as dire as you say it is, they might help you.

You may want to consider some counseling too.  Just talking through the emotion can help to reduce the stress.  Suicide attempts are only a cry for help and a therapist can really help you out.

[Paa_Paw]

Under some circumstances and with some policies it may be possible to establish a medical necessity based upon Psychological effects.

Beyond that, you might be entering into the area of insurance fraud which could get your insurance coverage cancelled and, in some cases, even land you in jail. A record of such fraud might make it nearly impossible for you to get any kind of insurance in the future.

If your insurance does not cover the surgery, You could always take responsibility for yourself and start saving the needed money to get it done honestly.

[tartan_tiger]

Under some circumstances and with some policies it may be possible to establish a medical necessity based upon Psychological effects.

Beyond that, you might be entering into the area of insurance fraud which could get your insurance coverage cancelled and, in some cases, even land you in jail. A record of such fraud might make it nearly impossible for you to get any kind of insurance in the future.

If your insurance does not cover the surgery, You could always take responsibility for yourself and start saving the needed money to get it done honestly.

I'm not looking to commit insurance fraud, I'm looking to not get screwed over by them because they don't think it's medically necessary and it's making my life unbearable and completely ruining it. I talked to my therapist today and was told that it's probably impossible to get it covered as a necessity based on psychological effects. I don't know how I could possibly save $60,000, it'd take me I don't know how many years.

[FreeinVegas]

If it truly is a life or death issue for you, consider a loan for the surgery.  Also, there are companies out there that help people finance medical procedures.  My PS's office offered me a brochure for a company that would pay for it and I could make payments to them.  It may take some research to find a company that would cover that much of an expense, but it is worth the look if you're in real bad shape from it.  With a loan of that size, you'll be paying for a long long time, but that's better than killing or severely maiming yourself with attempted suicide.  I don't know if we can put a price on happiness and confidence in life. 

[Paa_Paw]

Most policies specifically exclude cosmetic surgery. They are not screwing over anyone, that was done intentionally and openly to keep the cost of coverage down. If your medical coverage was purchased with cost as a major concern you could almost bet that cosmetic surgery has been excluded.

Medical necessity has been established for psychological reasons in some cases. This is not easy to do and it required the assistance of your primary care Dr. and a Psychologist as well.