About a year and a half ago my plastic surgeon submitted my request to insurance and it got approved removing 300g. I didn't go through with it, but when I went back now it had expired. At my consultation a few months ago my plastic surgeon said that she would submit another request. Today I called the insurance office and the woman told me that insurance does not approve any amount to be removed. She said that everything is post op and that they would examine if it was medically necessary then.
November 10, 2014
Answer: Under BlueCross BlueSheild Carefirst program, can Breast Reductions not be deemed medically necessary until post op evaluation? Unfortunately, it can be frustrating when dealing with health insurance companies; they are in the position to be able to “change the rules” when it comes to coverage for breast reduction surgery. You may want to double check the information received with another official from the insurance company. When I see patients in consultation for breast reduction surgery, I remind them that this operation is one of the most patient pleasing operations performed; it is worth being patient and persistent when dealing with health insurance companies. Best wishes.
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November 10, 2014
Answer: Under BlueCross BlueSheild Carefirst program, can Breast Reductions not be deemed medically necessary until post op evaluation? Unfortunately, it can be frustrating when dealing with health insurance companies; they are in the position to be able to “change the rules” when it comes to coverage for breast reduction surgery. You may want to double check the information received with another official from the insurance company. When I see patients in consultation for breast reduction surgery, I remind them that this operation is one of the most patient pleasing operations performed; it is worth being patient and persistent when dealing with health insurance companies. Best wishes.
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November 11, 2014
Answer: Insurance It sounds like your carrier used to do preauthorizations for breast reduction, but have stopped doing so. Unfortunately, this is their call. My hunch is that the carrier expects fewer women will go through with the procedure were there uncertainty about coverage. I suspect that had they previously decided that the procedure were medically necessary by pre-authorizing the procedure before, they would be hard pressed to say later that it was not.All the best.
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November 11, 2014
Answer: Insurance It sounds like your carrier used to do preauthorizations for breast reduction, but have stopped doing so. Unfortunately, this is their call. My hunch is that the carrier expects fewer women will go through with the procedure were there uncertainty about coverage. I suspect that had they previously decided that the procedure were medically necessary by pre-authorizing the procedure before, they would be hard pressed to say later that it was not.All the best.
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