Anyone had luck getting gyno covered?

[Idra]

I've been in the process of having some consultations for gyno surgery and most of the plastic surgeons I'm talking to basically keep telling me that it never gets covered by insurance.
I've done a lot of searching and have found a fair number of stories online about people who are able to get it covered via having a doctor write in about the pain it is causing or I also found some alluring to taking things to alter their hormone levels on bloodwork and thus creating a "medical" reason for needing it and having success that way.

My searches haven't yielded much regarding specifics or much recently so I thought it would be worth a shot to check if anyone has further information or any personal accounts that might help. I do have swelling and tenderness and it is something that I have had for multiple years and the pain has been documented in my medical history in the past but I still didn't get a very positive reaction from the plastic surgeon I just had a consultation with today regarding getting it covered by insurance.

I thoroughly appreciate any and all help as this is something I really want to get taken care of once and for all.

 

[Ashop]

I have heard of some getting it covered. Like you mentioned you could complain of pain and mental anguish and see if they will cover it. All you can do is try.

 

[snowpatrol]

Mine was legitimately pubertal and as such was covered since I'd complained to my GP about it around age 14 originally

If it's self-induced you may be able to stretch the truth but will probably have a tougher time getting insurance to pay

 

[Idra]

Mine is genuinely from puberty, but I was overweight growing up and never had pain from it so I never addressed it until later in life when I have started to have pain and tenderness.
I brought that up and they said it didn't make a difference because you have to have a medical hormonal reason to get it covered. (for example)
This is also why I was curious if getting bloodwork that shows super high e2 or something like that could help in any way.

 

[flexdurden]

Mine was covered because it stemmed from puberty and my hormones have been out of whack my entire life. Do the only way to correct the issue was surgery...

To answer you question about e2, that did factor in the decision (I believe) for my insurance company to cover it because despite using different AIs, the lumps never went away so the only option left was surgery.

 

[blackpantherusmc]

gyno

I have mild gyno and I take caber and anastrozole eod during my cycle.

 

[buck]

for every story you hear about insurance covering it there most likely dozens to hundreds of stories that you don't read about where they didn't. kinda like all the stories you don't hear about pit bulls not biting some one today!

 

[ThinkTank]

I am not sure why many here cannot get it covered. I have not had mine done, however I went to a "breast center" and had a biopsy.

It is my understanding, from speaking with the surgeon, that insurance will cover removal when done by a general surgeon. A plastic surgeon is NOT covered.

Of course this will vary by insurance provider. Family history of cancer and the fact that I did not say it was AS related. I told them I noticed it when taking Zantac.

I probably would go out of network to a person who specializes in the procedure as it relates to men (Dr. Blau comes to mind), and therefore would pay out of network.

 

[Matty2127]

Great posts

 

[DOHCrazy]

I was able to get it covered by BCBS because I had cancer at 19 and was 'high risk.'

Surgeries were at 20 and 22, one side each time.

Moral: get cancer before gyno.

 

[nfernoo]

I'm trying at the moment.

Here is what u need.
Mamogram and ultra sound.
High levels of estrogen while low test.

Complain of pain. Mention history of cancer
do not mention you don't like how it looks.
Simply say it hurts and you're afraid they will become cancerous. Tissue like this can and has been cancerous.
It's surprising to me that it's not covered

 

[mfcbastion]

I walked into a plastic surgeon's office a month after a contest and had them done. 100% covered. Said they caused me discomfort while sleeping. The doc told me to stop using "testosterone-boosting supplements." He knew what was going on lol.

 

[Idra]

If anyone has had theirs covered I would really appreciate it if you pm'd the name of the Dr. or plastic surgeon that did it for you.