Does blue cross blue shield cover gynecomastia?

[Yoshi]

I thought I read somewhere on this site that it did. Does anybody know what to say to them in order to get it? Do you have to say it causes "emotional stress" and such or is the process less painful with blue cross blue shield?

I saw an endo today and he said I was pretty much done with puberty (age 16). He said my gyno is a little bit of fat, a little bit of breast tissue, and loose skin (I used to be overweight and the loose skin is what is left over). He recommended to me a surgeon in the D.C. metro area, Dr. French. But if the insurance we have covers it, or the prices for Dr. French and Dr. Bermant are close to each other, I'd choose Dr. Bermant.

[SideEffects]

Years ago (1980), the doctor thought I had breast cancer in one of my breasts and did a masectomy.

When the biopsy revealed no cancer; just an enlarged breast, the insurance company treated it as “elective surgery.”   My boss could not believe that men could have breast cancer and did not want to pay medical leave time either.

[ItsOK]

There are many different Blue Cross/Blue Shield insurance plans.  I think you already know that you're talking in generalities when you ask the question, but you need to be sure that you know what your specific plan says.

Not that it's likely to help much . . . as someone else mentiioned, the coverage may vary depending on what the procedure finds.  It will also depend on how the submitting doctors code the procedure -- there are "diagonostic codes" and "procedure codes" for this purpose.  You should expect to have to go through the appeals process.

My advice would be to assume that the insurance is not going to cover the surgery and be prepared to pay for it out of pocket.  If they do cover it, great.  But don't put yourself in financial jeopardy by assuming they will pay and then find yourself in trouble because they don't.

And don't believe what anyone tells you before the fact.  You'll know that they paid when you have check in hand.  You'll know that they didn't when your last appeal is denied.