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  • Was Scheduled for Breast Reduction to help back...Not gonna happen..Now Depressed!!

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    Old 02-21-2005, 08:40 PM   #1
    TexasWildRose04
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    Unhappy Was Scheduled for Breast Reduction to help back...Not gonna happen..Now Depressed!!

    Hey All... Well I was feeling pretty good and on top of the world until this afternoon.... I had gone on the referral of my Neuro, to a Plastic Surgeon to see if I could get a breast reduction to help my back problems....and my insurance approved it.... The line between comestic and medically nessecary is removing 400 grams per breast... I was having 800 grams per breast removed... nearly 2 lbs. per breast... going from a DD down to a C cup.......Well, they set up the surgery date and I was to go on March 3 for a Pre-OP appointment with my plastic surgeon, then my reduction surgery was scheduled for March 9....Well, the billing department clerk called me this afternoon and proceeded to tell me that my insurance would pay 80% .. I am responsible for 20%... and I have a deductable that I have to meet because since it is a new year I haven't met mine for this year so far.. so she proceeds to tell me that I will need $968.00 and some change on March 3 when I come for my appointment...because the doctor requires it up front... I ask If I could make payments or something and she basically said... NO! he requires it upfront.... so I told her well, guess I won't be having the surgery right now then... so she says... "well when do you think you will have the money?" " I basically said... its not like I have nearly $1000 laying around, I am waiting for my disability to make a decision.. and I am not working right now... so I dont forsee it anytime soon....so she basically says... well, just let us know when you get the money....and hung up.... I must say, I am quite depressed, I so badly wanted to get this done, to possibly help relieve my lower and upper back and neck pain... along with they said it would help my constant migraines.... Oh well, when it rains it pours... Sorry, just had to vent a bit...

    Yall, Take Care.

    Last edited by TexasWildRose04; 02-21-2005 at 08:41 PM.

     
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    Old 02-21-2005, 09:03 PM   #2
    mel1977
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    Re: Was Scheduled for Breast Reduction to help back...Not gonna happen..Now Depressed!!

    vent all you need to, I am so sorry to hear this. It has been pouring over here for a few weeks now, so join the umbrella club. I think you should see about talking personally to your dr or maybe pass a note to his asst and see if he'd do something. I wish I could give you some great advice, but at this point, I am fresh out!

     
    Old 02-21-2005, 10:28 PM   #3
    misery
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    Re: Was Scheduled for Breast Reduction to help back...Not gonna happen..Now Depressed!!

    Rose I'm very sorry to hear what happened!Wish I could help with wonderful words of wisdom,but I'm not very wise.I however do feel for you.I know the money issue isn't good here either.
    That said,what the hell was up with the nurse and her attitude?It sounds as though she was quite rude with you on the phone!I think I would be saying something to someone there isn't any call for her to treat you like that.I hope I'm not reading something into it I had a lousey day also.Hang in there,Heather

     
    Old 02-22-2005, 07:00 AM   #4
    Quietcook
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    Re: Was Scheduled for Breast Reduction to help back...Not gonna happen..Now Depressed!!

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    Last edited by Quietcook; 07-16-2005 at 03:43 PM.

     
    Old 02-22-2005, 08:42 AM   #5
    heidi23
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    Re: Was Scheduled for Breast Reduction to help back...Not gonna happen..Now Depressed!!

    [QUOTE=Quietcook]Maybe if you spoke with the surgeon directly he would approve the payments over a period of time. They have many who would refuse to pay for the sake of refusing, but they know you need the surgery and a short face to face for a couple of minutes stop by the office may give you exactly what you need. Many surgeons are flexible if asked. Hope you will try that and sincerely hope it works out for you sooner rather than later.
    Quietcook[/QUOTE]


    I think that sounds like a good idea. If you talk to him/her face-to-face, they are more likely to listen to you and consider the individual situation, I believe. My pain management doctor waived my office visit co-pay last month because he knows how short I am on money right now.
    I can totally relate to your frustration. This back problem has cost me so much in co-pays, it's been really stressful, and it makes me angry too.
    I hope this works out for you and you get your surgery soon!!

     
    Old 02-22-2005, 10:16 AM   #6
    Jessie1
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    Re: Was Scheduled for Breast Reduction to help back...Not gonna happen..Now Depressed!!

    I'm so sorry to hear this! Definitely try talking to your doctor personally- he may agree to a payment plan or even waive the part of the fee you're responsible for. If you need to vent, we're here to listen! Please let us know what's happening. Good luck with everything!

     
    Old 02-22-2005, 10:22 AM   #7
    injured betty
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    Re: Was Scheduled for Breast Reduction to help back...Not gonna happen..Now Depressed!!

    Texas Rose: We have encountered this many times in the past. They want that darn co-pay, especially when it is plastic surgery or dental.

    Is there anywhere that you can borrow the money from? Family? Friends? Credit card?

    There are some doctors who will let you set up a credit plan. Maybe you should shop around some more, maybe go out of the area but make sure that they are on your preferred list for insurance purposes.

    When my daughter had her wisdom teeth out, even though she was inpacted and infected and running a fever, they told us, cash up front, over $1500 or now deal. We had to tap her college savings account.

    Or, you might have to wait until your disability check arrives.

    Hang in there,

     
    Old 02-22-2005, 10:41 AM   #8
    TexasWildRose04
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    Re: Was Scheduled for Breast Reduction to help back...Not gonna happen..Now Depressed

    Hey all thanks for your helpful advise....has given me a few ideas to try... I am going to try and call the surgeon and speak with him...and see if he will work with me.... and if that doesn't work, I have decided to try and get a loan from my 401k plan .... at least that way when I pay it back I am paying myself back with interest...I may have to postpone for a few weeks... maybe a month... but Ive waited this long... whats another few weeks...Again... Thanks alot for the input and advise...

    Take Care All

     
    Old 02-22-2005, 05:08 PM   #9
    Rampage
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    Re: Was Scheduled for Breast Reduction to help back...Not gonna happen..Now Depressed!!

    I agree...also, if you have some insurance options, you might be able to find one that doesn't require a deductible (or at least one a little lower).

    As difficult as this would be, asking for financial assistance from family or friends mights be a last resort. I HATE doing this, but my mom gave me $8k (Whoah) on Mother's Day, no less. But, I knew I had no choice, because IDET is rarely if ever covered by insurance. She, and the rest of my family, wanted me to explore every non-op options and thought it was worth it. It was actually meant to help fund my sister buy a house, so you can imagine how grateful I am to my family! They are the best.

    Just a thought...hope this helps.
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    Last edited by Rampage; 02-22-2005 at 05:09 PM.

     
    Old 02-23-2005, 08:40 AM   #10
    purplehazed
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    Re: Was Scheduled for Breast Reduction to help back...Not gonna happen..Now Depressed!!

    So sorry to hear about the derailment of your surgery. I hope you can get something worked out to proceed. I have two questions - did your doctor recommend the breast reduction? What kind of pain do you have and how was it determined as likely due to excessive frontage? I really feel that is likely partly the cause of my upper back pain and have mentioned this at one of my doctors appointments only to have it basically ignored. (Maybe I need to change to a female doctor?) I just had an MRI last Saturday and hope to get the results today, but no matter what it says, I'd like to request authorization from my insurance company for a reduction also. What I'd really like to do is strap some DDDs on the front of my doctor and let him pack them around for a few days!!! I am completely numb on my left side all the way around, under my left brest (which is the larger of the 2) up to the middle of my chest. I think the weight of my brest has been a main factor in this.

     
    Old 02-23-2005, 01:41 PM   #11
    TexasWildRose04
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    Re: Was Scheduled for Breast Reduction to help back...Not gonna happen..Now Depressed

    [QUOTE=purplehazed]So sorry to hear about the derailment of your surgery. I hope you can get something worked out to proceed. I have two questions - did your doctor recommend the breast reduction? What kind of pain do you have and how was it determined as likely due to excessive frontage? I really feel that is likely partly the cause of my upper back pain and have mentioned this at one of my doctors appointments only to have it basically ignored. (Maybe I need to change to a female doctor?) I just had an MRI last Saturday and hope to get the results today, but no matter what it says, I'd like to request authorization from my insurance company for a reduction also. What I'd really like to do is strap some DDDs on the front of my doctor and let him pack them around for a few days!!! I am completely numb on my left side all the way around, under my left brest (which is the larger of the 2) up to the middle of my chest. I think the weight of my brest has been a main factor in this.[/QUOTE]

    My Neurologist is the one that made the suggestion to me about the possible breast reduction... so he referred me to a Plastic Surgeon, who then did an exam.... I not only have my lower back problems, low back, hip, leg and foot pain, Sciatica, Lami/Disc L5-S1, June 04..... but also have upper back, neck and shoulder pain, horrible migraines, and also bra strap indentions in my shoulders, and rash under and between my breasts quite often....he told me that these were all typical signs of large breasts and that I was a prime canidate for reduction... he then submited a letter to my insurance company asking for approval to do the surgery... within a month I got a letter back from the insurance company saying I had approval... Like I said in my original post... Insurance requires I think he said 400 grams each breast to be removed to qualify as medically necessary, any less it is classified as cosmetic... I am supposed to have 800 grams per breast removed... close to 2 lbs each breast... he will be taking me from a DD to a C cup....

    Basically what you will have to do is get a referral to a Plastic Surgeon, let then decide if you are a canidate for reduction, and if so, The Plastic Surgeon will submit a request for approval letter to your insurance company.

    Best of Luck to you!



    Last edited by TexasWildRose04; 02-23-2005 at 01:43 PM.

     
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