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In addition to irritated skin tags, insurers also often don’t want to pay for steroid injection treatments for the painful overgrowing scars known as keloids, for the autoimmune hair loss known as alopecia areata, and even for painful cysts that form in the underarms or folds in the skin (hidradenitis suppurativa).
Yet I am frequently told that I have not sufficiently proven that.
To be clear, I don’t believe that health insurance companies should give patients carte blanche to have any and all cosmetic concerns treated and to have the costs shared by others in the insurance pool.
Not only did she loose much of her childhood by spending months at a time in a hospital, her cancer affected her development as well.
Many of her hormones were affected; as a result, her face and body didn’t develop normally.
I find it ironic that performing an extra evaluation (at extra cost) to confirm that the skin tag was benign adds credibility to my claim that its removal was medically necessary.
At what point does performing a biopsy of tissue that is conspicuously normal, in the service of taking care of patients, become fraud? I don’t want to miss a skin cancer, and though it’s rare, I’ve seen normal-looking skin lesions turn out to be cancers.Most people live long lives these days but many of them also develop chronic health problems, despite the pace of medical advances.We are living longer than ever, but not necessarily better.Dunn even felt as though she no longer resembled herself. In an attempt to return her nose back to the nose she was born with, Dunn spent over three times what she spent on her original surgery (Schamberg). Many women pursue cosmetic surgery in the hopes of gaining confidence; however, many are disappointed. This could give me license to biopsy everything, but that approach isn’t cost-effective and ignores the complications that biopsies can cause, such as scars, infected wounds, and the like.But as I strive to provide excellent care to my patients, I must often advise them against treatment for conditions that mainly affect their quality of life unless they can pay for it out of pocket.It’s entirely reasonable to create a set of priorities for how we spend our health care dollars.However, I think insurance companies’ priorities on what they will pay for do not necessarily match what can make real differences in people’s lives.This makes it difficult for people who want to have surgery for conditions that fall in the gray zone between cosmetic and medically necessary, difficult for the doctors who take care of them, and a challenge for insurers whose goal is to minimize their expenses.At the core of this issue is how we define the terms cosmetic and medically necessary.