POSTED UNDER Breast Reduction Reviews REVIEWS
Ready to Free My Boobies - Dallas, TX
ORIGINAL POST
Im 31 years old..mother of two girls. Ive been...
$7,100
Im 31 years old..mother of two girls. Ive been dealing with breast pain since ive been in high school. I developed at 12..was a 36dd by my sophmore year (early pregnancy) . When i was 18, i was scheduled for BR but as soon as i was prepped for surgery, i was pulled from the table.
State Medicaid (louisiana) decided not to pay..(mudducks) anyways..years later and im a 42f..200lbs (my breasts weigh more than the rest of my body) im in need of BR!! I cannot exercise due to my breasts being the way..i always end up with pinched nipples when i sleep at night...i have had one consultation where the doc took the photos but u know if u dont have insurance at the time of srrvice..they wont talk much.
UPDATED FROM tstarr
Not a good day for me...apparently my insurance...
Not a good day for me...apparently my insurance has an exclusion where it will not pay for BR surgery. They basically lied to me!! Dont use united healthcare!! Im canceling my insurance with them asap!! I need to find another insurance company asap!"
Replies (22)
March 8, 2012
We all have the same exact insurance plan, I was approved without a problem and it only took about three weeks to get a decision from them. If they have debied you, I say call them and start complaining because I know others that have gotten approved through them as well. You might also want to ask the doctor what information he sent because they will want pictures amount removed, etc. Good luck!
March 8, 2012
Thats weird. I was telling my husband the same thing. I saw where you were approved. What gives?
March 8, 2012
I have no idea, it can be a number of things. I didn't even have a referral from my primary care doctor. I just made an appt with the PS. I was actually shocked because I thought I was gonna have to have letters and everything but it wasn't an issue. If I were you I would call and ask to speak with someone in charge because it is a medically necessary procedure. Ask your PS office what info they sent and did they send pictures. Also find out the amount recomended to be removed, my PS suggested 1200 grams. There are also certain insurance codes they send that may have an impact on the decision. If the insurance company thinks for any reason it is cosmetic, they will deny it. Is your doctor in network? That may also have an impact. I read one person's blog that said the insurance company denied her with one PS and turned right around and approved her with another PS. If I can be approved without a problem there is no reason they should deny you without giving you an explanantion. So before you change insurance companies get as much info as to why you were denied, you might possibly need to look into changing your doctor. Quite frankly some of them care more than others and will have your back when it comes to dealing with the insurance company. Others want to just focus on their cash paying customers because it's less hassle. Can you tell I'm passionate about this? I don't think any woman should have to be in pain everyday. Don't give up, I hope this helps!
March 9, 2012
They told me that br was an exclusion in my policy. My PS called to verify my insurance with UHC. They (uhc) said they couldnt do it because it was considered an pre existing condition.
March 9, 2012
@Tstarr, That sounds like Bull!! Tell them u need what they are stating in writing, Ask your employer if BR is excluded from your PLAN. WHAT DO THEY MEAN ITS A PRE-Existing condition? R they kidding me?
March 9, 2012
I said the same thing @darkandlovely. Im guessing since its a short term insurance BR are automatically not paid by UHC. My PS said that UHC will mail me a denial letter.
March 9, 2012
Now I think they are lying to you. Pre existing condition? God forbid we have breasts before we get insurance! What the hell?? You need to talk to someone in a supervisory position. I believe they have nurses on staff that you can talk to as well. There is no way its excluded for you and not for me if we have the same plan.
March 9, 2012
Is your plan through your employer? I just got this plan & now im regretting it. Its short term so im wondering what the hell??
UPDATED FROM tstarr
I really feel like just giving up and dealing with...
I really feel like just giving up and dealing with the pain. Everytime i see a success story of a breast reduction on here, tears roll down my eyes. Maybe im one of those not so luck ones who have to suffer with the pain. I cant stand pain (im a big baby) and i hate the way i feel. I read my policy over & over wishing i could make the words change saying that my insurance could pay for the surgery but its something i have to deal with. So tata for now.
Replies (7)