Will Insurance Cover my Gynecomastia Surgery?

This question comes up frequently in consultation with many San Jose men. There are a lot of changes going on at this time with insurance companies so today’s answer may not be relevant in the future. The best way to find out if your particular insurance may cover your specific male breast reduction case is to ask at the time of your consultation. If there is any possibility for coverage, the doctor’s staff will be able to help you submit for pre-authorization.

Currently most insurance companies consider the removal of man boobs to be a cosmetic procedure and does not require to be medically treated, even though for many men it may cause extreme mental distress.

There have been cases that the severe gynecomastia breast has caused rashes, and pain. These conditions need to be well documented and submitted for possible consideration. Be prepared for an uphill battle that could take many weeks or months for a resolution that may not end in your favor. That being said, there have been cases that have been approved for coverage in the San Francisco Bay Area, your surgeon will best be able to tell you what your chances are. Those cases worth investigating for coverage are; genetic disorders like Kennedy’s Disease, and Klinefelter’s Syndrome, or hormone secreting tumors, breast cancer (rare and usually found only in men over 60)  or by a medical drug in treatment for a medical condition.

Posted by: Dr. Miguel Delgado, Jr. on Category: Gynecomastia, Gynecomastia cost

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