Author Topic: Few more questions...  (Read 1691 times)

Offline i_dont_know

  • Silver Member
  • ***
  • Posts: 106
Moving towards finally getting surgery, I'm about to make an appointment for a consultation sometime within the next few days.

For anyone who has had the surgery or knows about it... what's the deal with insurance? I know some doctors don't even accept it but are there some who do? And if so, how feasible is it to get some coverage? I've consulted my father on the issue and I think regardless I am going to end up getting the surgery, but he's asked me to find out about insurance and if there's any way to get the surgery covered. Also, does anyone know if you need a referral from your primary doctor to see a surgeon or does it not make a difference?

Thanks for any help you can offer.

Offline nitro1437

  • Posting Member
  • *
  • Posts: 33
the only insurance iv seen that covers it is kaiser and tri-care. im sure theres more but with most insurance coverage u have to have the insurance for at least  6 - 12 months before they will perform any major surgery or procedures, its just  one of the basic codes of health. also u have to see a general doctor. be referred to the endo and then refered to plastic surgery it is a long road but with determination it can be accomplished. also i would save at least 1000-2000$ for the co-payment , because most insurance that is not affiliated with your job or your parents job usually has an outstanding co-pay for surgery and also, sadley gynecomastia surgery is disputed as cosmetic surgery  with most health coverage agencies . but i would call around and maybe u will get lucky and find one. i wish you luck and do not give up.

Offline Paa_Paw

  • Senior Moderator
  • Senior Member
  • *****
  • Posts: 4779
Insurance policies vary greatly, there may even be several different policies written by the same company.

If cost was a major concern in the selection of your policy, then you can expect more things to be deliberately excluded.

Some policies rule out cosmetic surgery completely, while others allow it or not depending upon the circumstances.

With some policies you can self refer to a specialist while others require a referral from your primary care Doctor.

Unless you are familiar with the language of "Legalese", it may be simplest to just ask and see what kind of response you get from your insurance company.

Sometimes how you ask is important. I have heard of companies that would not allow payment for male breast reduction surgery as a general rule; But who would cover it if the person was suffering psychological distress which had been determined by one of their enrolled Psychologists.

Good Luck
Grandpa Dan


 

SMFPacks CMS 1.0.3 © 2024