Will Insurance cover surgery?

[pe175]

I think i have a mild to intermediate case of gyno.  If i decide to get surgery would United Health Care cover it?

[crabby5]

I've got BCBS and they'll cover only one doctor in Texas and only if it's big enough.

[Paa_Paw]

Gynecomastia to some extent is normal in a significant number of men.  Which means that insurance companies tend to consider surgical reduction / removal as being entirely Cosmetic.  Under those circumstances, They do not cover Surgery.

But there are three significant exceptions.  The first and most obvious is if there is pathology such as breast cancer; This is very rare in men.  Second would be if the degree of breast growth was profound; So large that it was causing physical problems.  Third is if the breast growth is causing significant emotional problems; this can be difficult to document.

Usually, you can count on being initially turned down but you will have a chance to appeal that decision.  Then it will be up to you to demonstrate that there is a legitimate "need" for the surgery.

It can be done, but will require you to do some heavy homework.  

Meanwhile, you need to see your Doctor and get a referral to an Endocrinologist so that you will have the gynecomastia and its cause properly identified & treated if necessary.  You will need to be past puberty.  If obesity is contributing to your gynecomastia, you will need to get your weight into the normal range for your height.  If there are emotional issues, a referral to a psychologist would be of great help in documenting that.

Good Luck.

[I-Hate-Gyno]

I've got BCBS and they'll cover only one doctor in Texas and only if it's big enough.

Crabby  

    I live in Texas as well, and I also have BCBS as my insurance provider. Did you get the surgery done? If you did how were you result (good I hope)? How big do the gyno have to be before it's covered by the insurance company?

[crabby5]

Hey.  No man actually my consultation is on Wednesday with Dr. Bailey.  Once I go I will know if they are covering it or not.  It has to be big enough and I don't know if mine is.  I really just have a very puffed up nipple on one side.  But I will see and get back with you and soon as my consultation is over buddy.

[I-Hate-Gyno]

Houston in the house....  

I hope you do get it done. I have had these breast's ooppss(gyno) from childhood, but if I loss body fat they go away a little. They are kind of big, but I hope big enough for BCBS to cover them. I am still waiting on my blood work and skull x-rays from my family practice doc.  Let me now if this dr. Bailey seem to now what he's talking about dude. Thanks

[I-Hate-Gyno]

One more thing bro. What is his web site address so i can do a little investigation on him.