I lost a little over 20 pounds..without trying mind you but my large breasts remained OUT OF CONTROL. I was still wearing a DDD. I begin experiencing back pain and taking otc pain medication. After a horrible and stressful Summer, I began to seriously consider a breast reduction. I also started seeing a chiropractor.
My then OBGYN gave me several plastic surgeon referrals. Nearly all of them didn't accept insurance and the one that did required that I go through several months of physical therapy. I put the thoughts of surgery on hold and continue to take my meds.
I had alot going on this year. I'd gotten engaged the year before and was planning a Spring wedding. My back pain started to creep up so I made seeing a chiropractor a priority. I'd meet my medical deductible by February so I was receiving adjustments several times a week. I'd also joined a gym. I made several appointments to see my doctor and was finally placed on meds. I knew further documentation would only aid in me getting approved.. By the Fall, I was ready to approach a new plastic surgeon.
During my visit with the plastic surgeon, the office staff was very reluctant in submitting the paperwork to my insurance. One lady even mentioned that she'd only known of Cigna to approve one case for breast reduction. I remained positive throughout the entire ordeal. I took an assessment and photos were taken of my breasts. The surgeon lifted my breasts up to where they should go..which is comical in itself and mentioned that I would be a full C after the reduction. I immediately pictured myself in strapless sun dresses.
Now due to the change in my insurance, it was agreed that we would hold off till next year to submit the paperwork.
Within the first two weeks of the new year, I contacted the plastic surgeon's office with my insurance info. The young lady didn't request for my medical records at the time but my paperwork was submitted..easy enough. Within a week I received a letter from Cigna stating that they would not cover the procedure. They felt it was not medically necessary. What? Did they not see the photos of my breasts? The letter went on to state: records do not show you completed at least one continuous three month trial of conservative treatment, such as weight loss, NSAIDS. They also apparently had not received the photos the surgeon took.
I immediately decided to go through the appeal process. I contacted my doctor's office to get more documentation. I went to my gym and asked if they could provide a record of my gym visits. The chiropractor even included a letter recommending the surgery. Once I gathered everything, I had over 40 pages of documentation. All of the paperwork was resubmitted to Cigna and within two weeks I received another letter that the surgery had been approved. I was so excited and immediately shared the news with my husband.