My daughter has congenital tubular breast deformity and is considered
severe. Breast reconstruction is recommended and scheduled. My
insurance is considering this cosmetic. Our doctor does not. I would
like to know what experience anyone may have with having this covered
thru insurance. I am trying to present a case to my insurance company
that shows that some companies do cover this, who they are and why
they covered the proceedure.

---

Request for Question Clarification by nancylynn-ga on 23 Nov 2005 17:24 PST

I have found very mixed and, overall discouraging, results so far.

Has your doctor argued to the insurance company that this is a birth defect?

Can the doctor verify functional impairment, such as the mammary
glands may be impaired?

Also ask your doctor's office if they feel it would be worthwhile for
to report this matter to your state's insurance commission.

I think it's wildly unfair of insurance companies to refuse to pay for
such surgeries, but based on what I've found, it's (sadly) fairly
typical.

Best regards,
nancylynn-ga
Google Answers Researcher