Insurance coverage for painful gynecomastia?

[nothingworse]

Hi,

My gynecomastia is a moderate case but, is painful and very uncomftorable.  I am done growing and my hormones are up to par. My doctor checked for testi lumps and there were none. Any of you guys think insurance would pay for the surgery since it involves pain? Also, seeing the GP or specialist on July 19th and wondering how long usually takes to schedule a surgery date. Week, two, more? Any information would be helpful.

[Grandpa Bambu]

Hi,

My gynecomastia is a moderate case but, is painful and very uncomftorable. Any of you guys think insurance would pay for the surgery since it involves pain?

If you are experiencing Gynecomastic pain, then have your GP document it and have her/him send a letter to your insurance company. At that point all you can do is hope for the best.

Good Luck Dude....

John out....

[ukman]

Hi

I got painful Gyno, some on here not heard of it but seems to be normal stuff.

I got rejected for insurance and am really pi**ed about it, I think the plastic surgeon didn't do the report in a good light.

The pain is in one nipple and if squeezed or push hurts, the lump is as big as a butter bean.

I once got it to go down to almost nothing, don't ask me how, just diet I guess but now back as before.

I am going to try Tamoxifen and Rebound XT but no one really says yes it works or no it doesnt.

[Grandpa Bambu]

I got rejected for insurance and am really pi**ed about it, I think the plastic surgeon didn't do the report in a good light.

That really sux my man! Sorry to hear....  :-/

However, not all is lost. Start saving your coin now and one day you'll have enough for sugery.  

John out....

[tammyvivi]

I have just been through that with my son and went through the entire appeals process with our insurance and was not successful  .   But there is good news!  I originally was trying to go through our local Children's Hospital and the cost was outrageous ($8,000), I happened upon this board and found other options I didn't really realize existed by asking more knowledgible questions when I spoke with the surgeons office.  Since my son is still a minor but adult sized in frame he would be able to be treated as an adult through a regular hospital.  The pediatric plastic surgeon I consulted with had a contract with a local hospital to do gyne surgery at HALF the cost that would be charged with Children's!!!!!!!!  So with that in mind I began consulting with non-pediatric general surgeons and plastic surgeons.  My son is scheduled for surgery on the 30th of this month with a cheif of general surgery at one of our cities hospitals for a faction of the cost ($2,500) .  One of the reasons for this is the hospital has a program for people who need plastic surgery with limited/no insurance that reduces the cost of all concerned.  We still had to pay up front but we are doing this with more left in the bank for his and our futures.  Not only that they were able to get us a surgery date within 3 weeks of our consultation.  Don't give up do more research ask for options and consult with many Doc's.

Best of luck to you.

[Grandpa Bambu]

My son is scheduled for surgery on the 30th of this month with a cheif of general surgery at one of our cities hospitals

tammy,

Congrats on your son's up-comming surgery!

Just a couple of questions.... how many Gynecomastic reductions has this 'Chief of General Surgery' done in the past? Does he/she perform the proceedure on a regular basis?

What technique will they be using to remove your son's
Gyne?

All the other Docs said my son's case was extreme enough to require the full mastectomy type of surgery.

A 'Full Mastectomy' type of surgery.

What does that involve? Like I mentioned above, what incision/removal technique is involved?


John out....[/b]

[nothingworse]

Thanks for all the responses. I have read that some insurance companies pay for gland tissue removal but, not lipo. Is the lipo more costly part of the surgery than the gland removal. I figure with savings and my parents helping out we could spend $1500. I am just wondering if the lipo would most likely cost more than that. If anyone knows please let me know. I hope I can get the surgery by August because school starts back up on September first. Mine is painful though, I can't lift weights anymore, have to position myself so I don't roll over on my stomach or I will wake up with a throbbing pain that lasts for hours. Can barely touch my nipples they are tender. What I don't understand that if you are experiencing pain insurance will cover it in other cases. I am not making any of it up or bs ing. If I had a painful large tumor I am sure insurance would cover it. But, it seems the insurance companies don't think much of gynecomastia even though it effects people mentally and physically. They aren't losing anything by covering this, what do we pay insurance anyways for. TO HELP US WITH PROBLEMS THAT EFFECT OUR DAILY LIFE BOTH PHYSICALLY AND MENTALLY. I just noticed something weird though. Its not something that just happened but, by closer examining my gynecomastia I have hard and lumpy tissue growth from the inner middle of my pectoral muscle to under my arm pit. Does this seem right? Mine gyne doesn't protrude more than and inch and a half outwards but, I notice and feel a lot of tissue length wise. Because of that it looks weird in a shirt and looks almost nothing like a masculine chest. Just a weird looking chest. Just wondering if any one else has a case of gyne that is similar to this shape? I know underneath the gyne my chest is a smaller more masculine chest but, with the gyne this way it just looks unproportional to the rest of my body, and I am pretty lean. 5'10" and 150 pounds. Any replies would be helpful. I just want the surgery done so I can get a job again which I will have a new one for a school CO-OP program in september and I want to weight lift again. Good luck to everyone on this board and hope I can finally beat this S**T once and for all. Its one of the only things that have been on my mind since I discovered what this was. Also, has anyone had their surgery done by a general surgeon and not a plastic surgeon. Just wondering if there would be a great difference in how good of a job they do?

[jc71]

I happened upon this board and found other options I didn't really realize existed by asking more knowledgible questions when I spoke with the surgeons office.

on behalf of all 5,500 members, your welcome.

[Grandpa Bambu]

Mine is painful though, I can't lift weights anymore, have to position myself so I don't roll over on my stomach or I will wake up with a throbbing pain that lasts for hours. Can barely touch my nipples they are tender. What I don't understand that if you are experiencing pain insurance will cover it in other cases.

The pains that you are experiencing are called 'Growing Pains' that in many cases, subside. Insurance companies know this and for that fact are unwilling to cover surgery costs.

I am not making any of it up or bs ing. If I had a painful large tumor I am sure insurance would cover it. But, it seems the insurance companies don't think much of gynecomastia even though it effects people mentally and physically.

Gynecomasia is not by itself a 'Life Threatning' condition. Many guys with Gyne lead happy and productive lives. Therefore, the insurance industry would say, "Well if that guy with Gyne can lead a 'normal' life, then why can't you?"

Insurance companies want to make money not loose it. Just like any other buisness... When Ins. Companies make good on a claim, they are loosing money. This, they do not like to do.

They aren't losing anything by covering this, what do we pay insurance anyways for. TO HELP US WITH PROBLEMS THAT EFFECT OUR DAILY LIFE BOTH PHYSICALLY AND MENTALLY.

Like I mentioned above.... whenever an Ins. Co. 'pays out', they are loosing money ( in their eyes ).

Dude, wake up and smell the coffee..... Insurance companies are NOT in business to "Help" you. They are in business to 'make money'. That is what modern western society is all about..... Being greedy and 'looking' good doing it!     Very sad isn't it?  :-/

You will be an insurance companie's best buddy until you make a substantial claim. If they have to make good on a claim in your name, they want nothing more to do with you. Bastards .

John out....

[tammyvivi]

Dear Nothing Worse,

I think you may need to consult with an endorcinologist, if you haven't already, before you go any further.  If you have a condition other than "just" gyne you may have more sucess with insurance.  Lumps should always be fully checked out to make sure you are taking care of the actual problem and not just addressing symptoms.  Best of luck to you, my heart goes out to you and your parents.  You are lucky to have the courage to go to your parents and have parent(s) who will help you in any way they can.

Dear Bambu,

The surgeon we selected has performed many of these types of procedures.  He will be removing most (full) breast tissue (mastectomy) including any under the arm (hopefully removing the risk of any growth back), he may do some lipo as needed when he is there and can see better what he is dealing with.  He will make an incision around the bottom of the nipple as small as possible.  He will not cut totally around the nipple as there is risk that the nipple could die off.

[Paa_Paw]

Some insurance companies are covering surgery but only if a medical need is demonstrated.  Because the issue is usually an emotional one with social withdrawal etc.  The best Doctor to see to establish the need for the surgery is often a Psychologist.