Author Topic: Approaching the situation  (Read 1678 times)

Offline Formula10

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Hey guys,
I posted here a little while ago and am now totally ready to start looking into getting the surgery. Although my finances are not completely in order, hopefully by the time i am ready to get the surgery they will be. I am estimating around 5k.

So now I am stuck with a question as to what the right move would be. Should i go to a general physician and tell them about the problem, then get referred to someone else? Or should I just go directly to a surgeon for a consult. The reason I am wondering is about insurance covering the surgery. Although I know it is VERY unlikely, that is why i am thinking option 2 (go directly to the surgeon) makes more sense, since the surgeon would probably file an insurance claim as well. Although It may get shot down, the chances of a mastectomy being covered are slim but possible.

So i guess i dont know what is best. Either way i am assuming insurance will not cover it, but i was just wondering what the best way to approach the surgery is. I am located in southern california, but any experience from anywhere would be helpful.

I would really appreciate your input!!
Thanks!

Offline alphajc

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If you want to have a shot at insurance coverage...go see your primary care physician first, then he'll likely refer you to an endocrinologist.  Then after you get write-ups from both, you might have a chance.  But it has to be a serious condition of gyne and also cause you physical/mental pain.  I've heard of people in this board get insurance to pay for them and all they had were minor puffy nipples, but this is the exception and not the rule and most likely you'll need to shell out the 5k.

Southern California has a lot of good board certified plastic surgeons in LA/OC and SD with experience in gynecomastia, it won't be necessary to travel.

Offline Paa_Paw

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Ditto.

Your primary care Doctor might even refer you to a psychologist if you are self image problems as a result of the G.

You should be prepared for the insurance company to reject your first request. Sometimes you could still get coverage through an appeal. Don't give up too easily.
Grandpa Dan


 

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