Breast Reduction Mess Up.Insurance won't cover corrections!!!

[Niki607]

Back in Feb I was approved by Empire BC/BS for a breast reduction due to severe back pain,spinal arthritis,and scoliosis.I'm only 21 years old & had 34E breasts and got reduced down to a 34D.Unfortunatly my left breast is a D and my right one is a C!!!My nipples are not the same size & my right one is hung down to the left too much due to the surgeon taking off too much skin & tissue out of the left side of the breast.The surgeon told me to let me heal & see if it gets better.Well were now into October & nothing has gotten better!On top of the other problems stated I also have holes all around my nipples from where the stiches were & very uneven scarring around both nipples.My surgeon told me he would request an approval to Empire in such a way that they would approve it so they could not say no due to it being"cosmetic",he titled it as a scar revision.I found out last week that they will not approve the revision due to them thinking it is "cosmetic".I need opinions on what to say to them when I call them to argue this.This is is beyond cosmetic!!it has affected me emotionally,physically,sexually,and my daily living!!
  First off how do they expect me to be able to find a bra!?I cannot find a bra that fits me because they do not make bras with two cup sizes.I will no long be able to enjoy summer because I am now too embarrased to wear a bikini or bathing suit.When it comes to my sex life with my fiance that has been totally ruined because I am too ashamed to take my shirt off in front of him,let him touch them,or anything else that involves my breasts.I cannot even wear a tight fitting shirt in public without having to stuff padding in the right side of my bra to make them look even.To deny the correction and say that it is only cosmetic is a huge understatement!!I cannot afford to have this corrected on my own and I did not want the surgery to be performed by who they picked to begin with.Any advice would be deeply appreciated.
  

[Howard Rosenberg, MD]

Fighting for insurance coverage is almost always distressing, particularly when asking for coverage for revision of a previously approved procedure.  Since you are paying for this coverage and are the owner of the policy, you will have to do the ground work to convince your carrier that the proposed procedure is for repair of the original covered procedure, and not merely cosmetic in nature.  It may be be a uphill battle, but if you're a "sqeaky wheel"  you may succeed.