Insurance for Endocrinologists??

[trojan213]

Does insurance generally pay for appointments/tests @ the endocrinologist? I have pretty good insurance (BCBS PPO)...

[Paa_Paw]

With a PPO, you will probably need a referral from your primary care Dr.

With the referral, The Endocrinologist will be covered usually with a co-pay.

Without a referral, you are on your own.

[moobius]

don't count on it... insurance deems gynecomastia surgery as unecessary and cosmetic. i had my doc write up a case for me and submit to insurance to get them to cover it -- denied. i even found the exact guidelines they use to determine if they cover it or not and both my doc and I felt i met the criteria... went to appeal and denied again. i could probably fight them on it, but it'll cost me more in legal fees than to pay out-of-pocket for the procedure. 

[Paa_Paw]

That is correct for a cosmetic surgeon, But the Endo should be covered at least partially with a referral.

[Grandpa Bambu]

I could probably fight them on it, but it'll cost me more in legal fees than to pay out-of-pocket for the procedure. 

Yup! They have us by the 'boys'....   

GB

[trojan213]

With a PPO, you will probably need a referral from your primary care Dr.

With the referral, The Endocrinologist will be covered usually with a co-pay.

Without a referral, you are on your own.

Dang ... any idea how much basic evaluation might cost including lab fees/tests? The only reason why I want to see an endo before surgery is because I'm 24 and have barely any facial hair... Downstairs and armpits have been about a decade, but I never really developed anything on the face. I'm pretty lean besides the chest, so I'm wondering if I have a hormonal problem.

[Paa_Paw]

Check and see if you can self refer. If not, since you have BC/BS try to get a referral from your Primary care Dr. and go through the process.

My referrals to a Vascular Surgeon and a Cardiologist last year cost me $10 each. Without a referral they could have cost Hundreds.