Monday, October 25, 2010


Friends, I'm really frustrated today. And I don't really know how else to vent it except to type it out. Is that ok? Also, here's a "Too Much Information" warning... if you don't like talking about boobs (& specifically MY boobs) this might not be the post for you. Sorry, tomorrow I promise to be back to normal with blogs about things that make me happy & will be breast-free, but today is not that day.

I'm just so frustrated with my health insurance. I want a breast reduction really badly & they're making it nearly impossibly for me to get the information I need to submit the information they need to approve it. I'm now set back at least 6 more months until I can even submit my appeal. Grahfgathhh!!! So I've decided I'm going to fight the man with any & all means necessary. I've mentally declared war on my health insurance. War face.

Here's what happened so far:

1) I called months ago asking for the guidelines used to judge "medically necessary" so that I could have all my ducks in a row by the time I see my surgeon... & I'm told they can't give me that info, they can only give it to my doctor. Um excuse me? You can't give me information on my own plan?

2) I saw my doctor, which was... you know... just a day at the beach to take your top off for a total stranger. Especially now knowing that it wouldn't have mattered anyway since my claim was denied. Don't get me wrong, my doc is great & I do feel comfortable with him. But still.

3) Denied. A little bit of crying & a lot of feeling defeated. But here's the best part... the letter they sent me is completely illegible. It looks like parts of the guidelines were copied & pasted but very sloppily. So again, I can't even get the information I need. How can I submit information when you won't tell me!?!
This is my example. See if you only received the highlighted text
you wouldn't know what this was trying to say either.

4) Starting from scratch. I finally now know I need to do 6 months of trying to correct all my symptoms through physical therapy, prescription meds, & such. Wouldn't that have been great to know MONTHS AGO when I originally asked for it? Yeah, I think so too.

I filed a complaint with my insurance about withholding information & they've entered it on my file, they're also sending me a new letter that I'll actually be able to read. In the meantime I'm going to do the 6 months they ask for. AND I'M GOING TO WAR. When I'm upset about things my natural reaction is to understand everything I can about it. So I'm researching every loophole, every tactic people have used in similar situations, every statement made by authoritative sources that show that I'm obviously eligible for this reduction. And I'm going to submit ONE HELL of an appeal. It's just not right... I pay for that insurance, YOU WORK FOR ME, so don't play these game with me just because you think you can. You can't, I'm going to get what I'm paying for from you, Mr. Heath Insurance.

*phew* That feels a little better. If you're still holding on after all that ranting, thank you. And if you have any advice or know a story that you think would fuel my war, I'd love to hear it. Thanks for allowing me to vent... I know it might seem silly to be so upset over just a boob job. But these things suck. And I'm upset. And friends care when friends are upset. And that's that.


  1. I can't believe I didn't think of this over the cousin (who just had the 11.8 lb baby)...had a breast reduction last year!! I'LL ASK HER what she had to go through, etc, etc... And, from what I can remember of her, you are much bigger than she was...

  2. I wrote something yesterday - I don't know why it didn't post. But I basically feel like this sucks! you keep saying you "want" this procedure but knowing your situation I really feel like it's something you need.

    I wish I could give you more help or advice on dealing with insurance companies but it not been a battle I won. I'm just impressed that you are taking charge of your health and you are choosing to be informed. Not everyone is as empowered as you are and I hope it goes well. I think the good news is that most people stop where you are pressing forward - maybe that will make things happen for you. Let me know what I can do to help!


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