dublingal07
New Member
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I’d love if anyone could help please.
Basically I’m with an Irish healthcare insurance company with no break in cover all my life and I have a high level of cover. I have never had an issue with the insurer paying out before for anything I’ve ever needed.
I had breast augmentation done privately in Ireland which has resulted in very painful grade 4 capsule contracture and ? query implant rupture / implant leakage.
I have no confidence in the cosmetic surgeon or the clinic where I had the plastic surgery completed so I don’t want to return to them to have the problem rectified.
Following review with my GP he referred me onto a general hospital for a series of consultations with specialist breast surgeons and scans. The necessary plan of action following these consultations and scans is that I need to have the implants removed and the capsular contracture removed in both breasts.
The surgeon wrote to my health insurers outlining the medical requirement to have the surgery completed and outlined the procedure codes for the procedures (1208/4557) however they have responded to say that their clinical specialist team have reviewed the medical details supplied on the case and that on this occasion they are not able to cover the costs of the required treatment/surgery as the treatment falls under the exclusions of the policy.
Now, I know for fact that this has been covered in other patients previously but these patients had to push hard to get the health insurer to pay and in the end they did. I am not looking to have the breast implants replaced (as I’d never put myself through anything like this again). I’m only looking to get the implants out and the CC removed and treated.
This required surgery isn’t cosmetic surgery but is as a result of cosmetic breast surgery which is why the insurance company are saying it’s not covered.
Has anyone any experience with this situation or can anyone offer me any advice? I don’t know where to start.
Basically I’m with an Irish healthcare insurance company with no break in cover all my life and I have a high level of cover. I have never had an issue with the insurer paying out before for anything I’ve ever needed.
I had breast augmentation done privately in Ireland which has resulted in very painful grade 4 capsule contracture and ? query implant rupture / implant leakage.
I have no confidence in the cosmetic surgeon or the clinic where I had the plastic surgery completed so I don’t want to return to them to have the problem rectified.
Following review with my GP he referred me onto a general hospital for a series of consultations with specialist breast surgeons and scans. The necessary plan of action following these consultations and scans is that I need to have the implants removed and the capsular contracture removed in both breasts.
The surgeon wrote to my health insurers outlining the medical requirement to have the surgery completed and outlined the procedure codes for the procedures (1208/4557) however they have responded to say that their clinical specialist team have reviewed the medical details supplied on the case and that on this occasion they are not able to cover the costs of the required treatment/surgery as the treatment falls under the exclusions of the policy.
Now, I know for fact that this has been covered in other patients previously but these patients had to push hard to get the health insurer to pay and in the end they did. I am not looking to have the breast implants replaced (as I’d never put myself through anything like this again). I’m only looking to get the implants out and the CC removed and treated.
This required surgery isn’t cosmetic surgery but is as a result of cosmetic breast surgery which is why the insurance company are saying it’s not covered.
Has anyone any experience with this situation or can anyone offer me any advice? I don’t know where to start.