Insurance Coverage for Male Breast Reduction
Over the years we have seen many male breast reduction patients who ask us this same question. The answer might not be what you want to hear; getting coverage is difficult at best and could be excluded at worst. It would seem logical for insurance companies to cover the cost of gynecomastia treatment because it is a bona fide medical condition.
However, gynecomastia treatment is considered by most insurance companies to be a purely "cosmetic" procedure so they shy away from covering it. This doesn't mean that all hope is lost!
We advise our patients to take the first step and find out if surgery is covered by their insurance. Look over your medical insurance policy or to give them a call. If they do cover the surgery, you're probably going to have to work hard to obtain coverage from them.
We've found that our patients may have to jump through hoops in order to appease their insurance company with proof that theirs is a medical condition needing cosmetic surgery attention. Our specialists are prepared to help you with getting you the information you'll need in order to file a medical claim.
The surgeons at Advanced Cosmetic Surgery of New York understand the physical and emotional challenges that gynecomastia presents and we are committed to helping our patients get the treatment they need. To learn more about payment options or to schedule a free consultation contact our practice today at 212-206-0023 or 631-499-1831.
Our Gynecomastia Team Offers Tips for Seeking Insurance Coverage
If you are prepared to stay on top of the claims process and work hard, then get ready for an adventure. Sometimes, insurance companies make it so difficult to pursue male breast reduction insurance coverage that some of our patients decide it’s not worth the hassle.
Here are some things that you may have to prove when approaching your insurance company to ask for gynecomastia surgery coverage:
- That you are suffering because of the condition both physically and psychologically (some insurance carriers may ask you to visit a specialist for an evaluation).
- The condition has been an issue for you for some time.
- You do not have an underlying condition such as liver or endocrine disease (because cosmetic surgery would not remedy the gynecomastia permanently) and that you have no prior history of illicit drug use.
- Your gynecomastia is a true medical condition (in the breast glands) and not a manifestation of being overweight or obese.
We Can Help Provide You with Documentation Prior to Gynecomastia Surgery
Though there may be additional requirements from your insurance company, it is not impossible to get your surgery covered. Our patients know that anything worth having is worth fighting for. If you are denied coverage, don’t be intimidated; you can always appeal the decision.
Our offices do not accept insurance coverage as payment for your surgery but we are happy to help you gather what you will need to file a claim. We do accept Care Credit (a credit card you can apply for) along with other convenient options to pay for your surgery if you won't be fully paying with cash.