Gynecomastia Surgery, also known as the surgery for reduction of the male breast, is generally not covered under many of the health insurance plans. Unless it is medically necessary due to the significant pain, discomfort, or emotional distress.
The main reason Gynecomastia surgery is covered is that it is considered a cosmetic surgery and not a necessary medical procedure. Moreover, the operation eliminates the enlarged or overdeveloped breast tissues in males.
However, if the operation is conducted for aesthetic purposes, health insurance or mediclaim will not cover the treatment.
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Furthermore, Gynecomastia can be a cause of physical pain and emotional distress for many men of various ages. If you are experiencing gynecomastia, you may be thinking about undergoing gynecomastia surgery, which is the best solution to end the condition. Yet, a common problem is whether insurance can cover the surgery expense. In this article, we will discuss if insurance is covered for gynecomastia surgery, offer advice on how to cope with the cost, and tell you why Dr. Ashish Khare, an expert in gynecomastia surgery, is the best person to assist you in this endeavor.
For a man, getting big breasts may be pretty uncomfortable. However, the enlargement of breast tissue usually does not cause health problems for males.
As emotional factors aren’t taken into consideration by health insurance companies at the time of providing coverage against a particular illness or treatment, patients generally fail to receive approval for a claim against male reduction surgery of the breasts.
A patient must fit specific criteria to obtain the surgery under health or medical insurance. The criteria are-
The patient must have glandular tissues and fat tissues, or growth of only glandular tissue. The surgery would be considered cosmetic if the patient has pseudogynecomastia (growth of only fat tissues).
The patient should be an adult and must have had the condition for 2 years or more.
The condition has become grades II, III, or IV.
The enlarged size of the breasts is leading to pain, discomfort, posture problems, etc.
The patient has stopped the drugs or medicines that caused hormonal imbalance in the first place and resulted in gynecomastia.
The condition did not go away even after removing the root cause.
Based on the policy bought, the costs for which health insurance covers gynecomastia surgery can differ. In general, the following costs can be reimbursed-
Gynecomastia surgery, a cosmetic procedure that reduces the male breast, is generally not covered by health insurance in India unless it is medically necessary due to pain, discomfort, or emotional distress. However, health insurance or Mediclaim will not cover the treatment. if it is performed for aesthetic purposes Costs include physician consultation, anesthesia, diagnostic tests, hospital admission, room rent, medications, and post-surgery consultations.
