Anyone else with BCBS off Illinois insurance?

  • TallOne
  • Davenport, IA
  • 2 years ago

I am 43 and am wanting a BR.  I am 5'11 and weigh 140 pounds, my frame is very thin (6 inch wrist circumference).  My breasts currently are a 34DDD.  When I gave birth to my last child (she's now 17!!) I was a G.  I've always had large, fibrous, heavy breasts, in 2003 I finally couldn't take the neck and shoulder pain anymore and went to my PCP for help.  I was too embarrassed to discuss the size of my breasts with him and so my diagnosis and treatment centered around the results of an MMR I had done....mild arthritis and degenerative disc disease in my neck.  I began to see a physical therapist and completed that and was sent home with a traction device to continue therapy on my own.  I have used this device throughtout the past eight years with only temporary relief ( lasting a few hours). I have seen my PCP several times since PT completion with complaints of continued neck, shoulder and middle back pain and was put on Tramadol (pain med) two years ago, I saw trememndous relief with this medication, however, I cannot continue on it due to the interactions it has with the SSRI meds that I take.  I WEILL NOT be able to continue working without this medication and am not a candidate for other pain medications (allergic to codiene and morphine).  I do have shoulder grooving from my bras and have self-treated for rashes.  My concern is this....getting BCBS of Illinois to cover the surgery regardless of the fact that I meet their criteria ( I think)  I have read that this particular company is THE most difficult to get approval from?  I am seeing my PCP on Dec 15th to discuss getting his recommendation and meet the PS on Dec 29th.  Any help is greatly appreciated, my lifestyle is beginning to be affected by this "ball and chain" attached to my chest!!

Comments (4)

I have BCBS of IL and my approval process was very easy. My OB/GYN started the process. Referred me to a PS who submitted the packet. She said the criteria was mostly about failed remedies such as support bras, PT, chiropractic - as well as about how much would be removed. My requirement was 450cc and this will be nothing. I received the approval about 3 weeks after it was sent in.
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Good luck! I hope things work out for you!
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BCBS of Illinois (it's the of Illinois) that is the supposed problem....other BCBS plans aren't as strict as this particular plan is.....I have decided to have the surgery regardless of insurance coverage, but so hope they will approve me!! Thanks for your input Aimee
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I have actually not heard this... There are lots of ladies around here who have BCBS like us and got approval with minimal documentation. I think with the things you have been through you will get easy and quick approval, I really do! I wish you the best of luck, it sounds like you really need it :)
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