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I was having a double mastectomy with reconstruction. But found out my insurance will not cover the reconstruction its $4000 OUT of pocket then the last surgery is a another $4000. I have blue cross blue shield hmo and the plastic surgeon needs a ppo so the only thing I can do is to put the surgery off intill next year and see if i can change insurance company. So now I have to call all the Dr's back and cancel everything we where ready to go November 21 . I hate putting this off . Instead of… read more
I am sorry you are having to deal with this, I think this is very wrong. If you can't rectify this, one good thing is you will be totally healed from mastectomy. So many women who begin reconstruction at the same time of surgery get infections . I really think it has a lot to do with everything being done at the same time. So you would get to heal before having reconstruction. Good luck to you. I was just trying to help you see a little bright spot with this disappointment. ❤️
See comment I posted to your other post regarding your insurance issues. They (insurance) are breaking the law and your plastic surgeons office should know about the law too and should have informed you of it and fought back with your insurance company to get your reconstruction surgery approved. How much insurance covers depends on your policy so you could end up with a co-pay, but they can't legally cover nothing as far as reconstruction goes. Blue Cross knows the law, they just don't know that you now know the law too and you and/or your surgeon's office are going to enlighten them about your rights. The law is called Women's Health and Cancer Rights Act (WHCRA) which became Federal law in 1998.
This must be incredibly frustrating. It's important to know that in the U.S., insurance companies that cover mastectomies are legally required to cover breast reconstruction surgery after mastectomy. However, coverage details depend on your specific plan and network requirements, as you've discovered with the HMO/PPO Show Full Answer
I meet with my insurance agent on November 12th. We're going to find a new plan that will find cover everybody all my doctors and reschedule in January. But I found out that starting January. The reason I gotta find a new plan. Altogether is because the plan I'm on now. With blue cross, blue shield will not be available next year. So I have to change everything. Anyway, still sucks. I was so ready to have this done. I had all my caregivers. Everything set up not gonna cancel and redo everything. 4 months out, instead of two months out
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