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Breast Reduction denied by insurance

spiritedcowgirl63

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spiritedcowgirl63    108

spiritedcowgirl63
Posted

Im a 34 DDD and want to get to a C. My insurance just denied me because not enough to remove. Anyone have ideas how to get this changed? I have back pain, headaches, divets in my shoulders.

Mikee57 reacted to this

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Mikee57    699

Mikee57
Posted

sorrycowgirl63 no help here, hope you can find someone to help...but I hope they figure out something for you.

☠carolinagirl☠ reacted to this

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Jersrose43    837

Jersrose43
Posted

Call them and ask for the written medical policy.

It will state what exactly you need to be approved

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☠carolinagirl☠    18,721

☠carolinagirl☠
Posted

Im a 34 DDD and want to get to a C. My insurance just denied me because not enough to remove. Anyone have ideas how to get this changed? I have back pain, headaches, divets in my shoulders.

i am sorry to read this..

did your PCD write a referral letter and advise this is a medical need for you?

this is what i had to do to have mine done..i say keep trying GF

CG

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Domika03    309

Domika03
Posted

I had breast reduction done prior to WLS, I was a 42DD, but my surgeon told me he thought I was bigger than that. I was very fortunate in that my surgeon took pictures of my breasts (no face, of course) & provided medical reasoning to have the surgery. It included documenting shoulder indentation from bra straps, marks under breasts from bras, constant back pain, and the inability to work out comfortably due to their size. I was approved almost immediately.

Ironically, as I lost about 110 pounds, my breasts are SMALL now! I am a 34 B (yes B). I call them my boy boobs now. Oh, the irony :unsure:

Ask the insurance company for their policy on coverage, then try to appeal it within their allotted time frame. You never know.

Good luck!

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spiritedcowgirl63    108

spiritedcowgirl63
Posted

Thanks for you input. I will appeal!

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Go To Topic Listing Plastic & Reconstructive Surgery

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