Pectus Excavatum: My Tips for Organizing Surgery and Finding an Insurance Cover
I’m currently running a website on Pectus Excavatum and also have the Pectus Excavatum chest deformity and a lot of people ask me for tips on getting insurance cover as well as how to approach the whole surgery situations and dealing with common difficulties with doctors who don’t seem to understand how pectus excavatum affects you and just tell you to get over it and tell you there is nothing wrong with you.
Feel free to comment or ask me questions in the comment section.
Choosing a doctor
This is probably the most important place to start finding a general doctor who you can trust and understands your problems and needs. This is most important because many people run into doctors who have no clue about pectus excavatum and call it things like whole chest and concave area and they will pretty much give you textbook responses to your questions and you will leave there office feeling like you just paid to have the dictionary read to you.
I have had this many times where I would ask a doctor if there is anything I can do to improve the appearance of the chest or get a surgery and they will always respond with “Don’t worry about it , just live with it” but that’s not the truth you don’t have to live with it if you don’t want to there are so many ways to improve your pectus excavatum including exercise (see my pectus repair hubs) and the most popular nuss surgery procedure.
Having a good understanding doctor will work in your favour in the long run as it will make getting referrals and convincing surgeons to carry out the surgery much easier and most importantly a good doctor backing you up is invaluable when trying to get insurance cover for the expensive surgical correction procedure.
Remember like any doctor if you are persistent with them they will have no choice than to give you a referral and if all else fails, contact the specialist directly as I have done in the past and it works fine just remember to work out your game plan just incase the specialist is a little hesitant. From the specialists I have seen I can tell you that they are very welcoming and wont push the surgery on you but will tell you that they will be happy to perform the operation and believe it can help.
The pectus excavatum surgery was long only considered for people with very severe pectus excavatum meaning it caused them real pain, pressure on organs or trouble breathing but now it is seen more of a cosmetic surgery. Which is good when you think about the trouble people went through getting surgeons to agree to do the procedure because know there are many surgeons all over the world doing the procedure.
With the surgery now being considered a cosmetic one, we have run into the trouble of the insurance companies being very had to convince to cover the costs of the expensive procedure. The key is to make it look less like a cosmetic surgery and more of a necessary surgery but I will talk about this later on.
Pectus Excavatum Surgery - Organizing the Surgery
So now for the part where you want to organize the surgery, this part will of course be a lot easier with a referral from your local doctor with a note describing your condition and difficulties you experience with the condition (usually heart pains, unable to take deep breaths, effecting fitness levels) that sort of thing. From my experience surgeons don’t need much convincing as It is considered a surgical procedure but for a difficult doctor, specialist or surgeon it is sometimes necessary to make the condition appear worse than it actually is by describing the troubles you experience.
To help support your surgery you should have most of the following including a local doctor referral letter 1- CT Scan of the chest / chest wall 2- Echocardiogram 3- Pulmonary function studies 4- Detailed note from your family physician on any significant past medical problems including your cardiac, respiratory and genetic history.
Pectus Excavatum Insurance Cover
The key to getting insurance cover for your pectus excavatum surgery if the insurance companies are being withholding is to be very persistent. There have been many cases I’ve heard of personally where people have scheduled a surgery and then hear the insurance company wont be covering the operation and having to cancel the surgery and get insurance cover back, this going on forth which can last a while and frankly drive you crazy when you know you or your child need the surgery.
The best way to handle this is to get the doctor and surgeon involved in the procedure of getting insurance some people even get the surgeons to call up the insurance company to give a formal description of your condition and why you need the surgery or get them to write a note to the insurance company. Most surgeons will write a note for you that you can fax over to your insurance company to support your claim but remember the most important thing to support your claim are the list of 4 things I mentioned above and these can be sent to your insurance agency.
Depending on your insurance cover , these sorts of operations will not be covered because they may see them as cosmetic but you can always try and push it to be more of a necessary surgery or at least get partial insurance cover on the surgery.
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