How to get insurance to pay for gynecomastia removal?

Question

I abused dangerous steroids. Gyno formed or was already there and grew intensely fast.I get flares of serious pain and swelling and growth even though I haven't touched a single steroid over 2 years. I managed to get a doctor to prescribe me in a hurry some anastrozadol because during the flare ups the pain gets so bad I can't wear a shirt.. I'm worried about the future health problems I might have if I continue to take these pills since the used to treat breast cancer in women. I have insurance

Jed H. Horowitz, MD, FACS · Answer

According to official statistics, 36% of adult young men and 57% of older #adult men in the United States have this medical condition in one of the four grades. About 200,000 to 3 million cases of #gynecomastia are being reported every single year. So if you have #breast #enlargement and you feel you're an exception, please understand that 1 in 3 young adult #men and 1 in 2 older adult men are just like you and have breast enlargement.

There are three types of surgical treatment options available that treat gynecomastia. Your board-certified plastic surgeon will recommend the type best suited for you. The most important decision to be made before performing any surgical procedure is determining whether you are an ideal candidate. Weight, and more specifically body mass index (BMI), need to be considered when deciding. Consulting with a board-certified plastic surgeon is highly suggested in order to determine if you are a surgery candidate and what treatments are best for you.

Typically, gynecomastia surgery is not always covered by many insurance or healthcare programs. If it is, it can take some time to acquire approval as criteria can be restrictive. If approved, it's possible to be reimbursed by the insurance company after the surgery. Nevertheless, most plastic surgery offices offer convenient finance plans that allow patients to pay a low monthly payment.

According to the American Society of Plastic Surgeons the average #cost of #gynecomastia surgery can vary widely. #Surgery quotes should include the procedure itself, operating room facilities, anesthesia fees, surgeon’s fees, medical tests, post-surgery garments, prescription medication and other related costs.  Costs will also vary with geographic location. Estimated costs can be found here on RealSelf.com, PlasticSurgery.org or Surgery.org.

It is imperative you select a plastic surgeon who is #board-certified and has a great deal of experience with male breast #reduction. Plastic surgeons who have specialized in breast surgery and cosmetic surgery are suitable to perform your procedure. Aside from checking board-certification, it is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Ronald Levine, MD · Answer

You'll need to contact your insurance provider to find out, but unfortunately, generally speaking it wouldn't be covered.

Marcus L. Peterson, MD · Answer

All insurance plans have different benefit levels as to what procedures they cover or do not cover. You will need to review the plan you purchased to see if this is included. Call the plan benefits office and ask if this procedure would be covered under your policy.  Most insurance plans do not include this kind of coverage. Best wishes,Dr. Peterson

Tom J. Pousti, MD · Answer

In my experience, most health insurance companies do not  help with correction of gynecomastia.  Best to check directly with your insurance company to see whether breast reduction surgery is a “covered” benefit with your specific policy.   You may find the attached link, helpful to you as you learn more about treatment options. Best wishes.

Mordcai Blau, MD · Answer

Unfortunately insurance does not pay for gynecomastia surgery.  How should I choose a surgeon?Choose carefully. The decision is yours. Advice to assist in making your selection.Only a board certified plastic surgeon1. Experience matters. Choosing a surgeon increases the likelihood that they have seen a case similar to yours in the past. Selecting a surgeon whose practice is focused on gynecomastia exclusively is also an indicator of experience.2. Results matter. The more before-and-after pictures, the better. Pay attention whether the surgeon is confident enough to show multiple angles of the same patient.3.Only gynecomastia Reviews matter. 4. Expertise matters. Is your surgeon recognized by the profession as an authority in the field? Have they authored books or medical journal articles regarding your surgery?Be realistic about your expectations. Also, revision surgery tends to be significantly more difficult than initial surgery.

Jay M. Pensler, MD - Account Suspended · Answer

Insurance does not pay for gynecomastia presently. The patients that have the strongest case are Klinefelter's patients but even my patients with Klinefelter's rarely are able to get insurance to reimburse the costs.

How to get insurance to pay for gynecomastia removal?

Answers (6)

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