Had Gyno removal surgery Oct 19!
Thought I could shed some light on the process, answer any questions, how I got insurance to cover some of it, etc.
If interested drop a question below and I’ll do the best I can to answer!
Hi Cap, I am interested in how you got insurance to cover, I think I remember you said you told them the gyno was causing you pain, etc. I have United Healthcare and wondering what all I will have to do to get them to cover a portion, I’m assuming it is a tedious process. Also if you’re willing to share, price of what your surgery would have been without insurance vs what it was with. Thanks in advance for your help on this.
@lynxpoint I have UHC as well.
You’d have to check your plan documents to see if there is a benign gynecomastia exclusion first.
But it’s a long process regardless. You have to prove that you’re not anything. No meds, no gear, no weed, etc. they require tests for all of it. If you are on anything, you have to drop for 6 months and retest.
If everything comes back in range and your doc submits the information, it’s an automatic denial code, meaning an appeal is required. That’s when you have to say that it’s causing you pain during everyday activities. I said, it causes me pain when pressure is applied. I mentioned sleeping, exercise, and even sex. That got the excision approved on the appeal.
Most doctors will want to perform liposuction after the mass is extracted, but lipo = cosmetic and most likely won’t be covered. I paid for it out of pocket but am still fighting it.
@CaptainAmerica I am going to get it done early next year and will just be paying out of pocket. I am in Colorado and was wondering what the prices were like where you’re at? Did you get put under or just local anesthetic? I heard the lipo feels weird lol.
How’s your recovery been?
@The_DGB2 Because I used insurance, my out of pocket is a little less. But my doc said paying out of pocket would have been somewhere 6-8k. The lipo part of mine was 5k out of pocket as insurance didn’t cover.
I’m feeling good. My chest actually has no pain and never did. What hurt was the drains he used. I even asked if I could go to the gym this week for just legs and cardio. They said no because of blood flow. I’ll ask again if I can go tomorrow.
@CaptainAmerica Holy shit, 5K just for the lipo? That’s robbery, man.
I’m glad you’re feeling good. I wanna get mine done so goddamn bad.
@The_DGB2 bandages came off today and I got gym clearance for legs and cardio. Let’s get it :muscle: