I had my consult for a breast reduction. The doctors office submitted my request for a breast reduction. Tricare came back and said they required a date for the surgery. They didn't approve or disapprove the request. The doctors office then scheduled my surgery for June 30th and will resubmit to Tricare for approval. How likely is it that Tricare will approve my breast reduction. Is it a good sign that they didn't disapprove it?
April 27, 2017
Answer: TriCare and breast reduction As long as you meet the criteria for breast reduction, you should have no problem getting your surgery approved.
Helpful
April 27, 2017
Answer: TriCare and breast reduction As long as you meet the criteria for breast reduction, you should have no problem getting your surgery approved.
Helpful
June 7, 2017
Answer: Breast reduction Hello and thank you for your excellent question. Unfortunately, dealing with insurance companies is often a challenging task. Your best option to see if your procedure is covered, is to contact your insurer to get details about coverage and requirements before approval for surgery (as you are doing). Given the difficulties of dealing with insurance, you can consider paying out of pocket for the surgery. For our patients, the out-of-pocket expenses for an insurance plan often approximate (or even exceed) the cost for the procedure. You can then obtain documentation from your surgeon to attempt to get reimbursement from your insurer. Any treatment plan should be based on a detailed discussion with equal input from both you and your surgeon. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results. Preoperative visualization and surgical simulation with the Crisalix system may help with your decision. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation in person with a qualified board-certified plastic surgeon. Good luck!
Helpful 1 person found this helpful
June 7, 2017
Answer: Breast reduction Hello and thank you for your excellent question. Unfortunately, dealing with insurance companies is often a challenging task. Your best option to see if your procedure is covered, is to contact your insurer to get details about coverage and requirements before approval for surgery (as you are doing). Given the difficulties of dealing with insurance, you can consider paying out of pocket for the surgery. For our patients, the out-of-pocket expenses for an insurance plan often approximate (or even exceed) the cost for the procedure. You can then obtain documentation from your surgeon to attempt to get reimbursement from your insurer. Any treatment plan should be based on a detailed discussion with equal input from both you and your surgeon. Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results. Preoperative visualization and surgical simulation with the Crisalix system may help with your decision. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation in person with a qualified board-certified plastic surgeon. Good luck!
Helpful 1 person found this helpful
