Beginning to navigate insurance -- sking for tips

June 23, 2006

Hi womens,

I was all set to go up to Dr. Melmed, but Shari opened my mind a

little and helped me to consider staying close to home, by

recommending her surgeon here in FL. Well, I did research yesterday

and found a doc on the explantation.com list, who is about an hour

away from me ( instead of 20 hours, like Dr. Melmed). He does en

bloc, and he's on my insurance plan.

Dr. Vinas --

His bio says this he has " ...specialized training in Breast Care as

well as cosmetic procedures such as midface suture suspensions,

limited scar vertical breast reductions, vertical breast lift with

internal suspension.... "

Here's my question: Anyone with saline implants actually get an HMO

to cover explantation costs? What are the steps I should take?

I got bloodwork done ANA, RA, sed rate, but am waiting for results.

Should I collect my records of the past year -- three visits to

cardiologist, three visits to urgent care with chest pain ( thought it

was heart attack), + regular visits to my primary care( for " anxiety "

joint pain, etc)

Who would I give that all to?

Do people actually get coverage before surgery, or submit and contest

it afterwards, once the implants were found to be faulty?

What happens if the implants come back " clean " -- is it possible to

prove the silicone shell was messing me up?

Would I be nuts to go in to the doc with a pile of papers citing

studies and such. I tried that with my PCP with the joint pain and he

frankly said, " I don't believe you. " Didn't even take the stuff I

brought him.

What to do now? I'm kind of attached to Dr. Melmed, but I owe it to

my family to go through insurance if I can. We have five kids.

Dawn

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