Insurance Companies
 

I would like to ask those who cannot be mature to leave the topic without reading further.

For those of you who are mature, I thank you.


I'm 16 and I suffer from a condition known as Gynecomastia. It's not a specific disease, but a condition that can have several different causes. It's basically when a man develops breasts resembling female breasts either in size or composition. My specific problem is caused by a delayed puberty. The estrogen in my body didn't turn into testosterone fas enough, so I developed glandular tissue in my breasts. The condition is exacerbated by naturally large pectoral muscles. I'm not giving measurements or taking pictures, but when I remove my shirt, it's very noticeable. This means that I always have to wear two shirts, sleep in a shirt, and wear a diving shirt whenever I go swimming. Often, I just avoid any situation where my condition might become known. I have gone to see several endocrinologists. They have told me that, at this stage, my condition will not reverse itself as time passes by like it does in some cases, and unless I get corrective surgery, I will live with this problem for the rest of my life. The surgery will cost around $20,000, which is the cost of my high school education and money my family doesn't have. We have appealed cases on both my mother's and my step-father's respective insurance plans. Both companies have turned my case down on the grounds that the surgery is purely cosmetic. While that is technically true, the psychological aspect of the condition is everything one would expect it to be and more. Yet, the companies continue to turn me down because they don't want to spend money on fixing my non-lethal condition.

What are your thoughts on this? Have you or anyone you know been turned down for an operation they rightfully deserved? Should the medical system be changed?

:< that's awful. I got in a nasty injury a few years back myself that resulted in nasty scarring-- I was on a trampoline, and I fell on it. No, not fell OFF. There was a net around it.... we were playing popcorn (a game where one person lays in the center and others jump around to give the person in the center a big jump), and someone threw some of those giant plastic balls on the trampoline. I landed on one, and fell wrong... my leg snapped instantly.

The whole thing resulted in a 8 hour wait in an emergency room (Lower Bucks= one of the worst hostpitals in my state) only to discover they didn't have the proper equipment to help me. So, two more hours then an emergency ambulance ride to the Children's Hospital of Philadelphia. I had to wait unti lthe next day to get surgery, too.... apparently that same week there had been 40-some odd leg injuries.

As it turned out, I had a spiral fracture. A very BAD spiral fracture: my Xrays got put in a medical textbook, that's how bad it was. Anyway, an external fixater and a full-body cast later, I can walk again. But the psychological effects are deep, and I'm very sensitive about the scars. Still, I don't think my insurance will pay for it either.

What I want to know is, why would you pour all that money into insurance and it won't cover you for the things you want? What's even the point of that?!

I don't know. I have a lump on my leg and I think I should pay for this because.... well I should. I don't know if it's comparable to your situation.

Honestly I don't really find it all that fair, but it doesn't shock me. Also I don't know where you live, but might you consider a public school education so you do not need to pay for at least that and money will be more available.

If you wish to try this in court or make some sort of law suit I think it could stand. I don't know I'm not really that knowledgeable in this category.