Author Topic: Need help with understanding the process.  (Read 1449 times)

Offline Etarc

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So first I'll give a little backstory, I'm a 21 year old male who believes he has gynecomastia. I've never done steroids or anything of the sort, and when I went through puberty (around 11 years old) I noticed I developed puffy nipples. I went through all the same things that I'm sure everyone on this forum have gone through. I can't remember the last time I took my shirt, always loved winter because I could mostly hide it with a jacket and so on. I have extremely "puffy" nipples, and about a golf ball sized lump in my left and right pec areas. Recently I've tried to lose weight to maybe help reduce it a little. I went from 255 to 215 (I'm 6'6" so I wasn't extremely overweight to start with) and I think my chest looks even worse now. I ran a cycle of pharma grade Letrozole for about a month (2.5mg a day) and didn't notice any decrease in gland size, just the lethargy and decrease of libido. So I figured it's time to bite the bullet and start talking surgery.

I looked up the prices for surgery, and there is not a chance I can afford it on my own. I'm the typical broke college student working part time, which barely covers my car insurance, much less a $7,000 surgery. So I started to look into insurance coverage, and as luck has it, I believe my insurance (Florida Blue Cross Blue Shield) actually does cover it if I meet certain pre-existing conditions.
"Mastectomy for gynecomastia meets the definition of medical necessity when ALL of the following exist:
  • Gynecomastia in post adolescent male;
  • Male is over age 18 years of age;
  • Tissue removed is glandular breast tissue and not fatty tissue; AND
  • Enlargement of the breast (glandular breast tissue) is not the result of obesity, adolescence, medications and or drugs (e.g., steroids, marijuana), reversible drug treatment, or endocrine disorder."


I believe I meet all the criteria, the only problem is I've never been to a hospital, never used any type of insurance for anything. The most I've done is go to a walk in clinic and pay cash for an x-ray. So I need some assistance as to what steps I need to take in order to make this a reality. Thanks to anyone who can help.

Offline Alchemist

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Hi Etarc,

I'll point out a SMALL hitch in your plan.
EXCLUSION:
Enlargement of the breast (glandular breast tissue) is not the result of ... adolescence ...,

Adolescent Onset:
when I went through puberty (around 11 years old) I noticed I developed puffy nipples.

Other than that, since they can't excise the fat, that is also excluded, you are getting a mastectomy by a surgeon, not a well done sculptured by plastic surgeon result is how I would interpret it.

First step of the process is to get yourself educated which various people might aid in your understanding and that is often started with pictures and your story to introduce yourself.  Welcome aboard.  Good luck.


 

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