Breast reduction denied by insurance

iVillage Member
Registered: 01-28-2013
Breast reduction denied by insurance
2
Mon, 01-28-2013 - 9:50am

I just found out that my insurance, Aetna, has denied me for breast reduction surgery because the PS won't be removing enought tissue.  He has estimated about 400g/each and Aetna wants 1000g/each.  

Has anyone out there had this same issue and did you appeal the decision?  I am planning to appeal and am trying to put together as much information to support the fact that the amount of tissue removed shouldn't be the deciding factor.  Any amount that can be removed will help with the back, shoulder and neck pain that I have.

Any help would be greatly appreciated.

Lynn

iVillage Member
Registered: 01-25-2013
Wed, 01-30-2013 - 9:07am

Call over and over and speak to someone new each time. Get letters from your doctor and appeal their every decision. Don't take no for an answer!

iVillage Member
Registered: 03-10-1999
Mon, 06-24-2013 - 8:05pm
can you document the back problems? chiropractor? physical therapy? this would probably help.