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Writer's pictureDanna Katzman

Insurance woes on the way to surgery #2

Tomorrow (Monday, Aug 6) I am having a breast reduction. It's an operation I considered having about 20 years ago but never did. Now I'm doing it just to "get my nipples in the right place" so I can have a nipple-sparing mastectomy in 3 months.

I have to be at Sibley Hospital at 5:45 a.m., so this post will be short. Surgery starts at 7:15a.m. I'm nervous. My first surgery ever was just a few weeks ago on July 12, to remove my ovaries and Fallopian tubes. Good riddance to them! But surgically changing the outside of me is much scarier.

I originally was not planning to take this step. Then I changed my mind and decided I wanted to keep these little pieces of me. Dr. Brown's staff submitted the information to United Healthcare for pre-approval, and they denied coverage! By law, insurance companies have to cover treatment for breast cancer, including mastectomy and reconstruction, and this law applies to people with BRCA gene mutations. While many insurance companies cover breast reductions before mastectomy, mine does not. Infuriating! They would not even let Dr. Brown call them to try to get them to change their minds. They would only allow a formal written appeal, and it would take 30 days to get an answer. I was worried that it would end in a denial again.

So, then came negotiating with Dr. Brown to pay for this surgery as a "cosmetic" procedure. They dropped their price by a few thousand dollars, but when you add in the cost for the surgery outpatient surgical unit and anesthesia, it's still going to be over $6,000.

The most expensive nipples in town!!!

I got to do some fun, distracting things this weekend, which helped. Yesterday, Larry and I went with our friends Bonnie and Gary to see "Three Identical Strangers" (good documentary!) and then out for dinner at a nice tapas place in Bethesda. Today, my friend Betsy gifted me her extra ticket to see "Dave," a musical at Arena Stage, with her and her Mom. Thanks, Betsy! It was a fantastic show and on its way to Broadway.


Dinner with Bonnie and Gary at Guardado's

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