Reconstruction and insurance

Helpful links on your rights to coverage...

https://www.cancer.org/treatment/finding-and-paying-for-treatment/understanding-health-insurance/health-insurance-laws/womens-health-and-cancer-rights-act.html

https://www.cms.gov/CCIIO/Programs-and-Initiatives/Other-Insurance-Protections/whcra_factsheet.html

http://www.breastcancer.org/treatment/surgery/reconstruction/paying-for

the last link gives some really good insight into why it may have been denied if you scroll past the questions that are kind of in the middle of the article. Dr D from NOLA points out where things can go wrong and from there you can go back to your dr to figure out how to potentiallyfix it.

TracyKin, I feel your pain! I am in Delaware with a Medicaid based insurance. I am very grateful to have the benefit of the insurance and am trying to learn as much as I can. I've only ever been on employment-based insurances my whole working life, until recently. I contacted a cosmetic surgeon's office who has a promising statement on his website. He preforms the tissue transfer I am looking into. Below is what his website states. I'll let you know how it goes.

"We have worked successfully for more than 10 years with numerous insurance companies and plans including commercial, self-funded, union, international, Medicare Advantage, Medicare and Medicaid as an out-of-network provider. In most cases, we have received approval for services by Dr. Levine at the in-network benefit level because of the highly specialized nature of the procedures he offers."

Oh no! Well, I'd certainly go with what other members have posted here regarding using any and all other resources you can utilize. Are you able to choose a new plan before the end of November or the year? Maybe a different Medicaid plan would cover reconstruction? We have two to choose from in Delaware, but they both offer coverage for reconstruction.