Not So Patiently Waiting on Br Approval from Insurance - Oak Park, IL

Hi. I'm 36 y/o with 3 children, youngest is 18...

Hi. I'm 36 y/o with 3 children, youngest is 18 months. I have had bigger boobs all my life or at least since they started developing. I was actually referred to get a breast reduction about 14 yrs ago but chickened out. I now wish I had gone through with it. My upper back, shoulders and neck hurts so bad now I'm getting these severe headaches. For me I want a breast reduction to alleviate or hopefully rid the pain I have. I'm in pain constantly and every aspect of my life is impacted. I have been referred from my PCP to see a surgeon because despite physical therapy, massages and many many pain pills nothing works. The surgeon thinks that having a Br will definitely receive my pain she thinks the only issue will be my insurance, Aetna. They want 1000 grms removed each side and the PS says 850/865 grams. So they may deny and we will have to appeal. I'm glad that we are going in the right direction but I'm so scared they will deny me. I have a tentative dare of surgery May 6th and preop April 21st. I'm just hoping that the look at what I'm going through before the reject it for only a difference of about 150 grams.


Well my insurance (Aetna) denied me. I found out today when I called. They day my surgeon has to do a peer to peer review. This is so frustrating. And I'm in so much pain why must I suffer through this for something that's medically needed to alleviate my pain? I'm so depressed.

Waiting on appeal decision!

Well they have denied the peer 2 peer SK I have moved on to the level 1 appeal. Sent all my documentation over and it was received as of April 26th they say they will have a decision in 15 days! At this point I'm not sure what to expect just want to be without being in constant pain. I'm trying not to think about but every time I pop another pain pill I can't help but to think that I could be pain free but instead they want to keep me in pain. I'm scared to call i don't want to be upset longer. If I have not received a letter by next Tuesday I will call.


Well this is now my second denial with Aetna! Its getting me really depressed now! But I'm gonna keep fighting but it's hard to fight when ur in pain. Otherwise I will be changing insurance during my Annual Enrollment and I will qualify with the new insurance. And I have a coworker that's approved for surgery July 28th and she didn't even have a history of pain like I do or didn't even need to submit anything.
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