Kaiser Permanente

[billy245]

Do any of you have any expierence or knowledge of dealing with Kaiser Permanente?

[ruggedtoast]

Who is Kaiser Permanente? Does noone know?

[uk2000]

i think gyne ops shud be covered by insurance.  i dont see it as a cosmetic op.  every man has the right to look like a man without having boobs.

[tford]

Sorry to send bad news but I have Kaiser Permanente and they denied my claim for surgery.  My Doctor thought it would be a shoe in but they came back and said that because it is a cosmetic surgery they wouldnt cover it.  I had the right to appeal but I decided to spend my time looking for a loan with a good interest rate.  Doesnt hurt to try but dont count on it like I first did.    

[Bluesun_Returns]

This topic was brought-up before, a couple of years back.  If I'm not mistaken, I think it was said that gyne-op is only covered by Kaiser in certain states.

As far as gyne not being a painful health issue, I think some would differ with that opinion, including myself.  Depending on the serverity of an individual's condition (how revealing it is), having gyne can be tremendously psychologically painful.  Believe me, I know.

[gynes_gay]

I have kaiser and my doctor said insurance will pay for it.  she also said thats it not cosmetic. So you guys are wrong its not cosmetic.

[Paa_Paw]

The sad news is that so many men have Gynecomastia that the insurance companies consider it statistically normal.

Making a case for medical need is somewhere between difficult and impossible.

[tford]

Gynes_Gay
I certainly hope the smily face meant you were kidding.  My doctor said Kaiser would cover my surgery as well and yet they didnt.  As far as whether its cosmetic or not, if your surgeon can convince the insurance company that it is not cosmetic than more power to ya!

[gynes_gay]

why would kaiser keep telling people that insurance will cover it then?

[tford]

Kaiser never says they would cover it, its the Doctors who say that they might.

[gynes_gay]

Well my doctor was positive that insurance will cover it for me. maybe because im only 15. Because she wasnt sure if insurance covers the surgery for adults.

[Bluesun_Returns]

Well, I'm personally not generally so sympathetic to the pyschological aspect because SOME people obviously use it as an excuse.  Gynecomastia doesn't necessarily come with pyschological pain.  Physical pain, on the other hand, is another issue.  If gynecomastia is coming along with a harsh physical pain that can't be remedied another way, I'd support insurance coverage.

That's just my view but I think there's good basis for it.  I know insurance companies have covered surgeries where psychological pain is involved.

I'll say it again, I think it's primarily depends on how servere your condition is.  However, that's not to say the doctors and insurance-companies' determination of it.

[oc_gyno]

Fast forward 9 years from this being posted. For all of those interested, I am having my surgery this coming Friday and it IS going to be covered by Kaiser. My copay will be only $10 for the surgery. Lipo and gland removal (if necessary). I will start a new post that will document pre and post results.

Good luck to all.

[MammaryMan]

And if you are on Medicare, try to find out what they think about it. You don't get an answer. You just get referred to  another entity connected to Medicare which again refers you to someone else until you finally get back to the original place you inquired. A consulting plastic surgeon also said insurance should cover it (painful, swollen glands) but his insurance person just got the runaround from Medicare.

So I am willing to go out-of-pocket for whatever it costs, but I think my case is exceptionally difficult because of size of the mammaries and my age (77). So finding an experienced surgeon close by is my problem.