Gynecomastia: Insurance Coverage and Surgical Considerations - Plastic Surgery

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Gynecomastia in males


Hello Dr.
Luo,
I would like to ask if gynecomastia treatment for males at Hsinchu Hospital is covered by health insurance.
If it is, will the out-of-pocket cost still reach five digits after the coverage? What are the contraindications or preparations needed for the surgery? I am scheduled to undergo penile curvature surgery on August 25th of this year.
Will there be any conflicts? Thank you, doctor.

Anbao Er, 20~29 year old female. Ask Date: 2002/08/23

Dr. Luo Qihua reply Plastic Surgery


The spirit of the National Health Insurance (NHI) is that surgeries related to aesthetic purposes are not covered.
Additionally, there is no specific coverage for surgeries related to gynecomastia in males.
Therefore, if a hospital or physician informs you that this surgery requires out-of-pocket payment, that is reasonable, and the cost may reach five figures.
Our hospital's breast surgery or plastic surgery departments apply for funding from the NHI for the excision of excessive breast tissue in patients with gynecomastia; however, the amount that the hospital can apply for from the NHI is limited and may be subject to denial.
Patients only need to pay the co-payment portion of the NHI (approximately one-tenth of the total cost).
Aside from patients with a tendency to bleed, which may lead to postoperative hematoma complications, there are no specific contraindications.
Most physicians will arrange for inpatient treatment.
This type of surgery will not affect the procedure you underwent on August 25.
Dr.
Kihua Lo, Plastic Surgery.

Reply Date: 2002/08/23

More Info


Gynecomastia, or the enlargement of breast tissue in males, is a condition that can cause significant psychological distress and discomfort. Understanding the insurance coverage and surgical considerations for this condition is crucial for patients contemplating treatment.

In many regions, including Taiwan, gynecomastia surgery may be covered by health insurance if certain criteria are met. Typically, insurance providers will require documentation that demonstrates the condition is causing significant physical or psychological distress. This may include medical records, photographs, and a letter from a healthcare provider outlining the necessity of the surgery. If approved, the coverage can significantly reduce the out-of-pocket expenses for the patient. However, whether the coverage will reach five figures depends on the specific insurance plan and the costs associated with the procedure, including the surgeon's fees, anesthesia, and facility charges. It is advisable to contact your insurance provider directly to clarify the specifics of your coverage and any potential out-of-pocket costs.

Regarding surgical considerations, there are several important factors to keep in mind. First, patients should discuss any existing medical conditions with their surgeon, as certain health issues may increase the risk of complications during surgery. Common contraindications for gynecomastia surgery include uncontrolled diabetes, bleeding disorders, or active infections. Additionally, patients should inform their surgeon about any medications they are taking, as some drugs can interfere with the surgical process or recovery.

Preparation for gynecomastia surgery typically involves several steps. Patients are usually advised to avoid blood-thinning medications, such as aspirin or non-steroidal anti-inflammatory drugs (NSAIDs), for a period before the surgery to minimize the risk of excessive bleeding. Smoking cessation is also recommended, as smoking can impair healing and increase the risk of complications. Patients should arrange for someone to accompany them on the day of the surgery and assist with transportation and post-operative care.

As for the timing of your upcoming penile curvature surgery on August 25, it is essential to discuss this with both your urologist and the surgeon performing the gynecomastia procedure. While these surgeries can be performed separately, the timing may need to be coordinated to ensure optimal recovery and minimize the risk of complications. Your healthcare providers can help determine the best approach based on your specific circumstances and overall health.

In summary, gynecomastia surgery may be covered by insurance, but it is essential to verify the details with your provider. Proper preparation and communication with your healthcare team are vital to ensure a successful outcome. If you have further questions or concerns, do not hesitate to reach out to your healthcare provider for personalized advice and guidance.

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