reconstruction deformity

jessiesmom1 said:

After my mastectomy and reconstruction I could have been a candidate for the TV show "Botched." Thank goodness my problem was fixable and my insurance paid for revision reconstruction without question.  Maybe this information will be of some help to you.

The Women's Health and Cancer Rights Act (WHCRA) helps protect women with breast cancer who choose reconstruction after a mastectomy. It says that insurance must cover: 1. Reconstruction of the breast that was removed

           2. Surgery and reconstruction of the other breast to make them symmetrical

           3. Prostheses needed before or during reconstruction

           4. Any physical complications at all stages of mastectomy including lymphedema

If you feel your rights have been violated then I would suggest you start the complaint process.

             1.Begin with the State Department of Insurance. They regulate companies that     provide health insurance. If you are in California then Kaiser is within the Department of Managed Care. I've worked for a major insurance company and those letters from the DOI were treated very seriously. They were a priority. 

            2. Contact the Cancer Legal Resource Center 1-866-843-2572

            3. Contact the Disability Rights Legal Center at www.disabilityrightslegalcenter.org

Please let us know if Kaiser becomes more cooperative with you.

IRENE

I greatly apprecaite your list of resources. I'll start down the list. I really should not have to do this.

As of today Kaiser refuses to correct the dent in my breast stating that my life is not in danger. It is cosmetic. And that any surgery is now considered elective. What the Hell....My depression is beyond anything that can be imagined. How can Doctors allow or even want half assed attempts?

I am physically deformed. I should be able to have Kaiser at minimum fix what was damaged.

There has to be others with this situation??? Anyone?

I appreciate any help anyone can give.

Depressed and feeling helpless

Teach76 said:

Insurance help?

Hi, Renee

    I have not had an experience such as yours, but may I suggest that you contact your insurance provider for advice?  I do not know what Kaiser is( facility?). I hope that you find some satisfaction soon.

 

Well to anyone considering reconstruction, implants and radiation RETHINK IT!! ask me for photos or what has transpired. I am defromed from the reconstruciton process and Insurance will not cover it.

As of today my insurance has decided that the deformity is cosmetic, is not life threataning and they will not cover any other procedure under insurance. Anything I do from this point forward to fix it through Kaiser is considered ELECTIVE!!! All out of my pocket. I can get a fix through another cosmetic surgeon and have the estimates, but why the hell do I have insurance then?

I have consulted with legal counsel and they stated they will need a substantial cash retainer and that Kaiser runs people bancrupt so they are not able to continue to fight. They stated it could take as many as 5 years to get any kind of resolution if ever. Kaiser knows this and they also demand that you go to mandatory arbitration so they keep this information out of the public arena.

I am beyond angry and depressed. Kaiser deformed me and refuses to fix it because my life is not in danger.

I am trying to work through my HR at a Government Job and am also getting no where.

I guess I will need to become a loud and strong public advocate, because this is ALL SICK AND WRONG! I can not be the only one that this is happening to. Class action lawsuit, plant myself with a poster on the public sidwalk of the hospital warning everyone of this deformity, file in district court??? Anyone??

I have been damaged through the process from Kaiser, I deserve to get put back without a dent in my breast at minimum. NO DENT - DO YOU HEAR ME KAISER!!!! NO GOD DAMN DENT!!!

Can Anyone help me? Please, the depression is overwhelming.