Has anyone gotten insurance to cover nerve grafting after mastectomy?
Community Member
3 months agoI am scheduled for a double mastectomy in early October. My plastic surgeon offers the resensation procedure (nerve grafting for the nipples). Unfortunately, United Healthcare has denied coverage even after the peer to peer and appeal by my pastic surgeon. Has anyone had United Healthcare (or any insurance) cover resensation? If yes, I'd love to know how you were able to get it covered. https://www.resensation.com/ if you are curious about this procedure. I find it frustrating that a procedure to have our anatomy actually have nerve sensation after a mastectomy is denied and deemed unnecessary. Thank you!
Accepted Answer
Insurance coverage for nerve grafting procedures like resensation can be challenging, and many community members have shared similar frustrations with getting these reconstructive procedures approved. Consider reaching out to other members who may have navigated similar appeals with various insurance providers - their experiences and strategies could provide valuable insights for your situation.
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Community Member
3 months agoI was planning to talk to my provider about this option and also have United Healthcare so that’s disappointing. Wonder if my Medicare will cover. What is the out of pocket cost? Maybe put it on Care Credit. You would think it would be covered for safety reasons as well…hot? cold? pain? I hope others will know more and comment. I will update once I talk to my provider mid October.
Community Member
3 months agoThe nurse said the UHC and Cigna haven't covered the procedure but Blue Cross and Blue Shield have. UHC considers it experimental. I asked for the estimated cost and just the hospital hours were $6k. I'm guessing it's a $20k procedure. Totally a guess.
Community Member
2 months agoAnother option may be to contact the company that developed the procedure and see if they have any studies you could enroll in. Sometimes they want feedback about how a procedure impacted your quality of life. They may reduce the cost for this feedback as well.
Community Member
2 months agoGreat idea!
Community Member
2 months agoInsurance coverage for nerve grafting procedures like resensation can be challenging, and many community members have shared similar frustrations with getting these reconstructive procedures approved. Consider reaching out to other members who may have navigated similar appeals with various insurance providers - their experiences and strategies could provide valuable insights for your situation.
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