I didn\’t miss your point the first time or the time after, etc. ;) I think I am swaying to your side. I mean, if the condition was life threatening, I am sure you would agree it should have been paid for. It doesn\’t SEEM* to be, so it shouldn\’t. Excellent point!
Thank you =)
*If there are facts not entered into evidence which make this disease life threatening, by all means, the ins. co. should pay for the surgery.
If it makes you feel better, I think your posts on the dog food thread were the most well written. I saw how people ignored your points, but consider the sources. Some people were trying to be funny, others were obnoxious. You were very serious in your posts. It was a very serious topic to you. I am not a pet person by any means. I don\’t understand firsthand how people view pets as their children. However, since I don\’t know how that feels (to be so attached) I would never even think to say that it doesn\’t feel the same to lose a pet as it does to lose a child. Cheers to you for being sensible and not sinking down to their level!
Ok since very few have acctually looked up this condition, let me share with you the other possibilities this condition brings:
Persistent pubertal gynecomastia — 25%
Cirrhosis or malnutrition — 8%
Primary hypogonadism — 8%
*****Testicular tumors — 3%****
Hyperthyroidism – 1.5%
Now does that satisfy those of you who still question if this is a medical issue or no?
And swaying back. :) You think Claudia\’s condition should be covered too, right? So many posts, I don\’t want to check back through.
Glad I am not the one who has to decide this one! I guess the argument was that it was cosmetic surgery. Technically, it was, wasn\’t it? But, on the flip side…
OK, it\’s good not to be in the health insurance business :)
Yes, Jewel, if this were a life threatening case, (and not just something that goes against the social norm), I would TOTALLY agree with this surgery. I do feel badly for the kid, but that doesn\’t mean exceptions should be made because someone is embarassed. I feel the same way about women who have breast augmentation to enlarge their breasts purely for asthetic reasons.
Bilateral gynecomastia refers to the benign enlargement of the male breast, either due to increased adipose tissue, fibrous tissue, or a combination of all three.
Concepts of medical necessity are based on the presence of a functional impairment. Typically no functional impairment is associated with gynecomastia. Therefore, determination of coverage eligibility for the surgical treatment of bilateral gynecomastia may require consideration of whether or not such sugery would be considered either essentially cosmetic in nature or reconstructive. (See policy Surgery No. 12 for further discussion of functional impairment, and general concepts of reconstructive and cosmetic services.) Contractual definitions of the scope of reconstructive services that may be eligible for coverage vary.
you know amazed, you spouted your mouth off, too. so your heroic attitude is for not. anyone who has taken any sort of sex education class (or even high school biology) would know this is just one of the \”dang, that\’s unfortunate\” conditions, not a life threatening one.
We have updated our privacy policy to be more clear and meet the new requirements of the GDPR. By continuing to use our site, you accept our revised Privacy Policy.
Claudia-
I didn\’t miss your point the first time or the time after, etc. ;) I think I am swaying to your side. I mean, if the condition was life threatening, I am sure you would agree it should have been paid for. It doesn\’t SEEM* to be, so it shouldn\’t. Excellent point!
Thank you =)
*If there are facts not entered into evidence which make this disease life threatening, by all means, the ins. co. should pay for the surgery.
If it makes you feel better, I think your posts on the dog food thread were the most well written. I saw how people ignored your points, but consider the sources. Some people were trying to be funny, others were obnoxious. You were very serious in your posts. It was a very serious topic to you. I am not a pet person by any means. I don\’t understand firsthand how people view pets as their children. However, since I don\’t know how that feels (to be so attached) I would never even think to say that it doesn\’t feel the same to lose a pet as it does to lose a child. Cheers to you for being sensible and not sinking down to their level!
Ok since very few have acctually looked up this condition, let me share with you the other possibilities this condition brings:
Persistent pubertal gynecomastia — 25%
Cirrhosis or malnutrition — 8%
Primary hypogonadism — 8%
*****Testicular tumors — 3%****
Hyperthyroidism – 1.5%
Now does that satisfy those of you who still question if this is a medical issue or no?
Amazed-
And swaying back. :) You think Claudia\’s condition should be covered too, right? So many posts, I don\’t want to check back through.
Glad I am not the one who has to decide this one! I guess the argument was that it was cosmetic surgery. Technically, it was, wasn\’t it? But, on the flip side…
OK, it\’s good not to be in the health insurance business :)
Yes, Jewel, if this were a life threatening case, (and not just something that goes against the social norm), I would TOTALLY agree with this surgery. I do feel badly for the kid, but that doesn\’t mean exceptions should be made because someone is embarassed. I feel the same way about women who have breast augmentation to enlarge their breasts purely for asthetic reasons.
Hmmmm…Amazed….this is what I found….
Description
Bilateral gynecomastia refers to the benign enlargement of the male breast, either due to increased adipose tissue, fibrous tissue, or a combination of all three.
Concepts of medical necessity are based on the presence of a functional impairment. Typically no functional impairment is associated with gynecomastia. Therefore, determination of coverage eligibility for the surgical treatment of bilateral gynecomastia may require consideration of whether or not such sugery would be considered either essentially cosmetic in nature or reconstructive. (See policy Surgery No. 12 for further discussion of functional impairment, and general concepts of reconstructive and cosmetic services.) Contractual definitions of the scope of reconstructive services that may be eligible for coverage vary.
Lisa, it\’s a pleasure to have a debate with a person who is willing to educate themselves before shooting their fingers off.
:o)
I commend both of you. That is what I was trying to relay earlier. There is a need to review and research things before we judge.
Please, it only takes common sense to know boobs aren\’t life threatening.
you know amazed, you spouted your mouth off, too. so your heroic attitude is for not. anyone who has taken any sort of sex education class (or even high school biology) would know this is just one of the \”dang, that\’s unfortunate\” conditions, not a life threatening one.