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Tuberous Breast Reconstruction This forum is for the discussion of the specific issues regarding tuberous breast reconstruction.


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Old 03-06-2019, 03:19 PM   #1  
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Chicago area tuberous breast doctors, insurance help please!


Hi! I would LOVE any and all advice I can get regarding doctors that specialize in tuberous breasts that are in the Chicagoland area (preferably south Chicagoland). I'd REALLY love advice on getting a BA covered by insurance. I have Aetna if that makes a difference. Even if there's a good chance of getting denied, I'd like to try. I just don't know the steps to take to get that started. Thanks!
PS: My left is just about a level 4 and my right is a level 3. My right is bigger than my left. Does any of this help my chances of it being covered?
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Old 03-06-2019, 05:25 PM   #2  
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Have you checked out Dr. Pelletiere? He has experience with tuberous breasts. I'm not sure if he accepts Aetna or not.

This is from his website:
"For reconstructive procedures, we are contracted with most insurance companies. For those companies we are not contracted with, we will still work with them to ensure that the majority of a patient's reconstructive work is paid by insurance and not the patient."
Chicago Plastic Surgery, Plastic Surgery Chicago, Inverness Plastic Surgery
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Old 03-06-2019, 07:56 PM   #3  
 
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I donít want to be a Negative Nancy However, I just want to prepare you for the reality that it is HIGHLY unlikely that your surgery will be approved for partial or full insurance coverage. Congenital Breast deformities are typically only covered if their are multiple deformities happening at once (for example: Polandís syndrome AND constricted Tuberous Breast) or if the deformity is also causing a physical issue. And sometimes not even then. It is very difficult to get covered. That said, if you still want to try, Dr. Pelltiere office should be willing to help you try! PS staff want you to get surgery and they will help in any way they can to get you the money. They donít care if itís insurance, loans, cash, credit, whatever! Call and ask them to help you submit a request for coverage. If you get denied, ask for help filing a appeal.

Have you considered using care credit or another medical finance agency?
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Old 03-06-2019, 08:08 PM   #4  
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Quote:
Originally Posted by Lennev View Post
I donít want to be a Negative Nancy However, I just want to prepare you for the reality that it is HIGHLY unlikely that your surgery will be approved for partial or full insurance coverage. Congenital Breast deformities are typically only covered if their are multiple deformities happening at once (for example: Polandís syndrome AND constricted Tuberous Breast) or if the deformity is also causing a physical issue. And sometimes not even then. It is very difficult to get covered. That said, if you still want to try, Dr. Pelltiere office should be willing to help you try! PS staff want you to get surgery and they will help in any way they can to get you the money. They donít care if itís insurance, loans, cash, credit, whatever! Call and ask them to help you submit a request for coverage. If you get denied, ask for help filing a appeal.

Have you considered using care credit or another medical finance agency?
Thank you both! I called his office but it was after hours so I have to make an appointment with him tomorrow. I am not expecting to get it covered, and I'm planning on doing a cash/cedit combo, but I want to at least try the insurance route, because it doesn't hurt to try. I don't have any expectations, but who knows!
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Old 03-06-2019, 08:21 PM   #5  
 
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Thank you both! I called his office but it was after hours so I have to make an appointment with him tomorrow. I am not expecting to get it covered, and I'm planning on doing a cash/cedit combo, but I want to at least try the insurance route, because it doesn't hurt to try. I don't have any expectations, but who knows!
Thatís right, girl! You never no until you try and the worst thing that can happen is they say No. I wish you the best of luck and I hope Iím wrong... I hope you get approved! That would be so cool!
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Old 03-17-2019, 09:10 PM   #6  
 
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Tuberous


Hey I had tuberous breast two thrmeee are photos in my album my insurance denied mine as well and this was before I had children, as it isnít a medical necessity. ... I hope they approve yours but if they donít I highly recommend saving towards one. My BA was the best thing Iíve ever done for myself and always wish I would have done it sooner.
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03-24-2019 08:18 AM
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