Breast reduction surgery

11 posts in this topic

hey guys
i have a bit of a weird question... and i apologize in advance if this makes some uncomfortable.
I am inquiring about a surgery for breast reduction. I gave birth to a son 2 years ago, and every since my back started to hurt progressively more due to the fact that my already large breasts have got even larger  after becoming a mom. I made an appointment to see my gynechologist and hopefully get a referal... but from what i understand this type of surgery also requires approval from the health insurance (AOK). 
Does anyone have any experience with this? If yes, how can I improve my chances of getting this paid by AOK? I feel it would make a bit difference in my health and overall well-being. 
Thank you

cherry

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Just now, lisa13 said:

why don't you call AOK and find out what they need wrt documentation to cover it?

Yes I will go there tomorrow and inquire about it. I first need a refer frommy doctor, which I will see in about 2 weeks.

 

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Ask AOK what you´d need. If you have back problems they will probably want an expert opinion from an orthopedist. You don´t need a referral for that.

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11 minutes ago, Cherryalessia said:

Yes I will go there tomorrow and inquire about it. I first need a refer frommy doctor, which I will see in about 2 weeks.

 

 

Sorry to be silly, but nearly googled what a "frommy" doctor was.  Lack of sleep I guess.  Hope it all goes well for you.

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normally if a doctor is willing to write up treatment as medically necessary, that should be good enough for the kasse.  Note you could see your HA for something like this, too, as your actual discomfort is not in your "lady parts" per se, but in your back!

 

my FA was giving me the runaround when I needed an MRI to get a better picture of a uterine fibroid (lady parts, indeed) and even in that case I ended up getting referred by an internal medicine specialist, no kerfuffel whatsoever.  The point is, don't let your FA have the final word if they are not assisting you properly.

 

but I also have to ask, what kind of referral are you looking for from your FA?  This is no longer a hard requirement anymore for most situations - you can go to a specialist on your own without an überweisung unless that specialist demands one.  You'd have to find a specialist who will do this kind of surgery, of course.  Verify that with AOK, but I handled all the legwork for my surgery on my own aside from the referral for the MRI.  Found a surgeon, he took me, piece of cake.  If I'd waited for my FA to get it together I'd still be suffering instead of free of the damned thing.

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This is a well documented and recognised medical problem for some women.

You need a medical assessment to show this causes back/ neck pain. Maybe also an assessment regarding your psychological  issues related to this problem. 

As others said- AOK will let you know what is needed.

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1 hour ago, lisa13 said:

normally if a doctor is willing to write up treatment as medically necessary, that should be good enough for the kasse.  Note you could see your HA for something like this, too, as your actual discomfort is not in your "lady parts" per se, but in your back!

 

my FA was giving me the runaround when I needed an MRI to get a better picture of a uterine fibroid (lady parts, indeed) and even in that case I ended up getting referred by an internal medicine specialist, no kerfuffel whatsoever.  The point is, don't let your FA have the final word if they are not assisting you properly.

 

but I also have to ask, what kind of referral are you looking for from your FA?  This is no longer a hard requirement anymore for most situations - you can go to a specialist on your own without an überweisung unless that specialist demands one.  You'd have to find a specialist who will do this kind of surgery, of course.  Verify that with AOK, but I handled all the legwork for my surgery on my own aside from the referral for the MRI.  Found a surgeon, he took me, piece of cake.  If I'd waited for my FA to get it together I'd still be suffering instead of free of the damned thing.

 

Thank you! 

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I’m having surgery this week, and I was surprised that when I took the Einweisung to my health insurance (TK) two weeks ago, they barely looked at it. They simply stamped it and gave it back to me.

 

I got the impression that as long as a doctor says the surgery is necessary, the insurance simply approves it.

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A friend of mine had the same surgery,  also in Munich.  She paid for it herself.  I think mostly because she wanted to get it done and not run around getting various doctors to sign off on it.  She is very happy with the results and has a completely different posture now.  

 

As everyone else has said: talk to your insurance and don't be afraid to get a second opinion.  

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@Cherryalessia You didn't mention having tried the gym. If it's really just the back ache bothering you then imho that should be the first thing you look in to.

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