POSTED UNDER Breast Reduction REVIEWS
5' tall and 32G's - The ball is finally rolling ! - Panama City, FL
ORIGINAL POST
I've been researching breast reductions for years...
$85,000
I've been researching breast reductions for years and I've finally decided to get the ball rolling ! I've asked around and decided my first action would be to change my insurance provider. I went with BCBS because of the ease of communication and they are pretty much excepted everywhere plus I made sure they had a decent specialist co pay which is what I needed due to my other health issues.i looked up PS that were covered by them and my journey begins there with a little bit of background story. I used to be an event bartender back in 2012 and the PS I chose (Dr.Ceydeli) was having an event at the party and was passing out free consultation cards. I kept it for years and came to find out her was covered by BCBS. Fast forward to 2015 post college graduation and I'm ready to start this journey!
KayC2014's provider
UPDATED FROM KayC2014
6 months pre
1st BR consultation!!!
So I went to my first consultation with a plastic surgeon ever on July 1st,2015. My appointment was at 8:00 Am and with the drive time from Tallahassee I had to hit the road pretty early but I got there just in time. I invited my mother who was probably more excited than me to come and experience this with me. We walked into the beautiful Plastic Surgery and Spa Center waiting room and after filling out paper work we were in the consultation room.
The nurse walked in and had me fill out a breast reduction bio note. This pretty much asked me what kind of pains I had with my large breast including , shoulder grooving , how many pillows I sleep with, my bra size , any medical issues I've had with my breast, etc. After filling out this form she told me to undress and Dr. Ceydeli would be in shortly. He came in and the first thing he said was " is this your sister ? " and my mom just lit up haha! ( For a 63 yo woman she doesn't look a day over 45) then shot a look Over to me and expressed about how little I was to have such a large chest (5' even if I haven't expressed that yet) and heavy at that. He suggested that at a minimum he could take 350g out of each breast but would like to get as much as 500g ( I was super excited to hear that!!). He also suggested lipo suction on my sides and back to make me even and the flatten my armpit area also know as Accessory breast tissue. The insurance will not cover that so $1500 out of pocket isn't that bad.
After the consult he said it would take about a month to receive a answer from the insurance company YAY. So fast forward to last week and I haven't RECIEVED AN ANSWER !!! I called to the office and the accountant told me that the " breast reduction form" was misplaced !! I was devastated!!! She did call the next week to say that it was found and I should find out something if not by the end of this week then next week! I'm excited keep your fingers crossed for me!!!!
The nurse walked in and had me fill out a breast reduction bio note. This pretty much asked me what kind of pains I had with my large breast including , shoulder grooving , how many pillows I sleep with, my bra size , any medical issues I've had with my breast, etc. After filling out this form she told me to undress and Dr. Ceydeli would be in shortly. He came in and the first thing he said was " is this your sister ? " and my mom just lit up haha! ( For a 63 yo woman she doesn't look a day over 45) then shot a look Over to me and expressed about how little I was to have such a large chest (5' even if I haven't expressed that yet) and heavy at that. He suggested that at a minimum he could take 350g out of each breast but would like to get as much as 500g ( I was super excited to hear that!!). He also suggested lipo suction on my sides and back to make me even and the flatten my armpit area also know as Accessory breast tissue. The insurance will not cover that so $1500 out of pocket isn't that bad.
After the consult he said it would take about a month to receive a answer from the insurance company YAY. So fast forward to last week and I haven't RECIEVED AN ANSWER !!! I called to the office and the accountant told me that the " breast reduction form" was misplaced !! I was devastated!!! She did call the next week to say that it was found and I should find out something if not by the end of this week then next week! I'm excited keep your fingers crossed for me!!!!
Replies (7)
August 13, 2015
Congratulations on going for it! I will keep my fingers crossed for you! And so glad that you have a mother that supports you.
August 14, 2015
Thanks love !!! I think my mom wants me doing this as much as I want to do this ! Pageant dress shopping has never been an easy feet with these girls strapped on my chest !
August 14, 2015
I'm keeping my fingers crossed for you too! I'm playing the waiting game also to see if my insurance will approve the surgery. Praying that I get an answer next week. Good luck to you!
August 14, 2015
Good luck to you too Hun !! It's a long process but it will be soooo worth it in the end ! Let me know if you hear anything !
August 19, 2015
I had my breast reduction done on Aug.10th. Dr. Ceydeli is amazing! I'm 38 and I finally have perfect beautiful breast that actually fit my body. You will love them!!
UPDATED FROM KayC2014
5 months pre
Whelp ...DENILE
So after a long battle with paperwork, my PS office on call backs , photos , hoping and praying I was denied my breast reduction request by my insurance. I'm normally not easily upset and have a very tenacious attitude toward things that I want but this really hit hard for me. I've been wanting this procedure for as long as I can remember and when I finally have the opportunity to go forward with it I can't. I spoke to my mother about it and she thinks it's due to my insurance being BCBS select which is considered "ObamaCare" . I honestly don't know where to go from here. I can't afford the surgery on my own and I definitely don't want my parents to pay for it. Does anyone have any advice on what's the next step ... Should I try another Dr? So I need more paperwork deaming this medically necessary ? Help please !
Replies (4)
September 23, 2015
Call BCBS and ask what else needs to happen or what additional information they need in order to approve this for you. I also have BCBS, although it's through work and not an individual policy. BCBS required at least a year of non-surgical treatment for pain and discomfort associated with large breasts - ie chiropractor, physical therapy, etc. Oh, and a recent mammogram.
They also required substantiating information, records, and letters from my other doctors - I got my general practitioner, my OB-Gyn, and my chiropractor to submit information and records supporting my need for a reduction.
Once all that was submitted, they reviewed the case and approved it.
Again, things might be different if you have a different type of policy - BUT talk to the person at your plastic surgeon's office about how to go about getting the surgery approved. They should have lots of experience in this area. I know the woman at my doctors office did. We worked together on getting all I needed for about three months.
Beware of an office that tells you something is approved and you have no information and communication from your insurance company! That happened to me this summer too. I went to two different PS's, just to see who I felt more comfortable with. The first one called me after about two weeks to tell me my surgery had been approved - BUT I never heard from the insurance company. She also told me that my OB-Gyn had written a persuasive letter in my favor.... WELL I eventually decided to use the second dr, and called my OB-Gyn to see if he would submit the same letter of support... and he said he'd never written a letter! I wonder now if that first doctor was being like an ambulance chasing lawyer!!! If I'd believed them and hadn't tried to check it out, I would've had surgery, assuming it was covered, and be stuck for a huge bill I couldn't afford b/c it never was submitted.
Anyway - just beware and be patient. Talk to the doctor's office and the insurance company about everything they need. And keep good records, and re-submit in the future. They should eventually approve it.
They also required substantiating information, records, and letters from my other doctors - I got my general practitioner, my OB-Gyn, and my chiropractor to submit information and records supporting my need for a reduction.
Once all that was submitted, they reviewed the case and approved it.
Again, things might be different if you have a different type of policy - BUT talk to the person at your plastic surgeon's office about how to go about getting the surgery approved. They should have lots of experience in this area. I know the woman at my doctors office did. We worked together on getting all I needed for about three months.
Beware of an office that tells you something is approved and you have no information and communication from your insurance company! That happened to me this summer too. I went to two different PS's, just to see who I felt more comfortable with. The first one called me after about two weeks to tell me my surgery had been approved - BUT I never heard from the insurance company. She also told me that my OB-Gyn had written a persuasive letter in my favor.... WELL I eventually decided to use the second dr, and called my OB-Gyn to see if he would submit the same letter of support... and he said he'd never written a letter! I wonder now if that first doctor was being like an ambulance chasing lawyer!!! If I'd believed them and hadn't tried to check it out, I would've had surgery, assuming it was covered, and be stuck for a huge bill I couldn't afford b/c it never was submitted.
Anyway - just beware and be patient. Talk to the doctor's office and the insurance company about everything they need. And keep good records, and re-submit in the future. They should eventually approve it.
September 25, 2015
I am so sorry about this news, I know exactly how disappointed you are. I had BCBS 8 years ago when I had my very first consult for a BR. They didn't flat out deny it, but like Texazpepper said, they required additional documentation, and physical therapy. At the time I couldn't afford weekly PT sessions, so I didn't pursue the surgery. I agree with the other ladies, find out exactly what they require, or appeal it. Don't give up girl, I'm praying for you!
Replies (2)