Breast surgeon for teen (BCBS federal)

[Anonymous]

OP, I would call a breast surgeon’s office and get their rec’s for PS. I loved the doctors at Sibley Breast Center, and one of the PS they recommend is Dr Bruno in Chevy Chase.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:My teenage girl really wants/needs breast reduction surgery. She is a 32G and it interferes with sports, makes it very hard to find clothes, and results in bathing suits looking too revealing no matter how hard we try to find one that fits correctly.

We found a surgeon we liked but they just notified us they no longer take our insurance - BCBS federal. I have researched the requirements for coverage and it would be covered under their policy under the circumstances.

Does anyone have a surgeon they recommend?

Thank you!

That is not medically required surgery. No health insurance will cover that. It's a cosmatic surgury.

That's not necessarily true.

We went to Dr Friedman’s office and very much liked one of the surgeons there, but they no longer take our insurance.

It's not cosmetic if its causing pain/back issues/etc. OP said she did the research- so no reason not to believe her.

No, but a word of caution -- "doing the research" isn't the same thing as "pre-authorization." So she probably wants to confirm it will be covered rather than just "doing the research" by reading the policy.

OP, you want to go to Dr. Roger Freidman in Rockville. Best plastic surgeon in the DC area.

[Anonymous]

Anonymous wrote:Can’t speak specifically to reduction surgery.

But our daughter required a different surgical procedure, and we found the surgeons at Children’s Hospital in DC to be the best.

HOWEVER: the rest of that hospital is severely lacking. The nursing staff repeatedly made mistakes in pre care, after-care, bill coding, etc. The hospital strives to hire from the local community to provide opportunities.

The hospital provides care to any and all regardless of insurance/ ability to pay, and the waiting rooms are constantly swamped. Stress level there is very high. Parking is a nightmare.

We are considering Childrens for plastic surgery. How did these issues play out on the day of surgery? Did the surgery start on time? What procedure did you have done?

[Anonymous]

The PP who thinks it won’t be covered has no idea what they’re talking about.

My breast reduction at 20 was covered. It’s very common.

[Anonymous]

I had my reduction done by Stephen Baker at Medstar Georgetown in 2019. I also have BCBS Federal, and it was fully covered. Dr. Baker was wonderful and was able to get everything approved through insurance. I only paid the surgery co-pay.

https://www.stephenbakermd.com/

[Anonymous]

Anonymous wrote:I had my reduction done by Stephen Baker at Medstar Georgetown in 2019. I also have BCBS Federal, and it was fully covered. Dr. Baker was wonderful and was able to get everything approved through insurance. I only paid the surgery co-pay.

https://www.stephenbakermd.com/

Your age?

[Anonymous]

Anonymous wrote:

Anonymous wrote:I had my reduction done by Stephen Baker at Medstar Georgetown in 2019. I also have BCBS Federal, and it was fully covered. Dr. Baker was wonderful and was able to get everything approved through insurance. I only paid the surgery co-pay.

https://www.stephenbakermd.com/

Your age?

I was 36 at the time of consult and 37 when I had the surgery

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I had my reduction done by Stephen Baker at Medstar Georgetown in 2019. I also have BCBS Federal, and it was fully covered. Dr. Baker was wonderful and was able to get everything approved through insurance. I only paid the surgery co-pay.

https://www.stephenbakermd.com/

Your age?

I was 36 at the time of consult and 37 when I had the surgery

Completely different scenario than OPs daughter.

They are going to advise that she wait until she stops growing. And insurance is going to want a documented history of back issues that would justify a reduction.

Insurance companies decisions are still heavily weighted toward dealing with an problem after it is a problem instead of taking a preventive route.

[Anonymous]

I cannot imagine BCBS FEP covering this and I have the same insurance.

[Anonymous]

Anonymous wrote:Op here; leave it to DCUM! I was excited to see the number of responses thinking I was getting recommendations. We have talked to several doctors over the last two years, as well as our insurance company and her pediatrician. Believe me, it’s medically necessary and will be covered. I wasn’t trying to get into that here. Thank you for those who provided recommendations. We actually went to children’s and liked the doctor - but experienced exactly what PP described. Billing department gave me nonsense estimates, couldn’t coordinate with insurance competently, and repeatedly did not call me back. This will be DD’s first hospital experience ever and I didn’t want to deal with logistical issues, it made me lose faith in the medical care.

I would recommend Dr Bruno or Dr Brown in CC or Tysons.

[Anonymous]

I am not in DC and don’t have a surgeon to recommend. However, my dd had breast reduction surgery at age 18 and it was covered by insurance. At that time, insurance coverage was based on the amount of tissue that would be removed. Given the size of my daughter’s breasts, they determined that enough would be removed to trigger insurance covered. I have two nieces who also had surgery around that age and it was covered by insurance.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Can’t speak specifically to reduction surgery.

But our daughter required a different surgical procedure, and we found the surgeons at Children’s Hospital in DC to be the best.

HOWEVER: the rest of that hospital is severely lacking. The nursing staff repeatedly made mistakes in pre care, after-care, bill coding, etc. The hospital strives to hire from the local community to provide opportunities.

The hospital provides care to any and all regardless of insurance/ ability to pay, and the waiting rooms are constantly swamped. Stress level there is very high. Parking is a nightmare.

We are considering Childrens for plastic surgery. How did these issues play out on the day of surgery? Did the surgery start on time? What procedure did you have done?

DD was about 6 months old and had to have a non-essential organ removed.

Day of, everything went smoothly. But billing was coded wrong and a nightmare to correct.

A few years later, one of us had cancer treatments at Washington Hospital center (same complex). Yet again - same problems: cancer required a special diet and kitchen made wrong food, nurses were clueless. Treatment required hourly showers, but hot water was out. Nurses were rude and not competent; the complex was dilapidated, overcrowded, etc.

Nevertheless, the actual MDs they employ are top notch.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I had my reduction done by Stephen Baker at Medstar Georgetown in 2019. I also have BCBS Federal, and it was fully covered. Dr. Baker was wonderful and was able to get everything approved through insurance. I only paid the surgery co-pay.

https://www.stephenbakermd.com/

Your age?

I was 36 at the time of consult and 37 when I had the surgery

Completely different scenario than OPs daughter.

They are going to advise that she wait until she stops growing. And insurance is going to want a documented history of back issues that would justify a reduction.

Insurance companies decisions are still heavily weighted toward dealing with an problem after it is a problem instead of taking a preventive route.

Can we let the topic of will it or won’t it be covered go now? OP has been clear she believes the surgery will be covered, if it’s not, well that’s an OP problem, not a you problem. Anyone else considering this has been sufficiently warned as well.

[Anonymous]

Anonymous wrote:Anyone saying overly large breasts are not a medical condition, does not have overly large breasts.

I (finally) had a breast reduction at 48 and it's the single best thing I've ever done for myself. Better posture, no more daily back pain, no groove marks in my shoulders, and yes, clothing fits and looks better, and I can buy bras in a regular store, that are actually cute!

My insurance covered it, and I will fully support my DD if she want to pursue the same path when she turns 18.

I am 52 and seriously considering it. I am enormous (as in, a J cup). I recently spent 5 days without a bra (I did not leave the house - Lol) and I still have major grooves in my shoulders. I haven’t been able to run in years, and I can’t row (my boobs get in the way). Back pain, skin rashes… the list is never ending.

[Anonymous]

Give her body time to catch up before making life altering decisions