You certainly sound like a good candidate for a reduction. You should discuss your symtoms with your physician. Many HMOs require a referral from your primary physician. If you are denied, there is probably an appeal process that you can undertake.
I'm 27 years old, 5'0" and I weigh 130 lbs. I am considering getting a Breast reduction, currently my breast size is 36DD.
I am having lots trouble with breathing, sleeping, neck and back pain and grooving in my shoulders from bra straps. I also have had a problem with a sebaceous cyst under my right breast. The cyst had to be surgically removed after rupturing.
Am I a good candidate for this surgery? And if so, How can I get my horizon HMO blue cross blue shield to cover the surgery?
You certainly sound like a good candidate for a reduction. You should discuss your symtoms with your physician. Many HMOs require a referral from your primary physician. If you are denied, there is probably an appeal process that you can undertake.
Based on your physical description and symptoms, you certainly sound like an excellent breast reduction candidate and one for whom the procedure should be considered "medically necessary." Keep fighting for coverage, and if they continue to resist, save the money to have it done.
You are a good candidate for breast reduction (reduction mammoplasty). Do not be upset if your initial request for pre-certification is denied by your insurance company. Be sure to ask for an appeal; if there is another denial, ask for an appeal with the physician reviewer being a plastic surgeon... more
It seems that you will benefit from breast reduction. Insurance approval is a completely story. Your physician will be able to help you to get the approval. It helps to have track records for all your complaints documented by your primary care physician. At the end the insurance company might deny it even... more
It sounds as if you are an excellent candidate for a breast reduction. The problem will be convincing your insurance company. First discuss this with your primary care giver. He/She will have to review your medical history and will be the first step in determining whether the HMO will approve... more