Gynecomastia possibly covered by insurance and the FAA

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Wheresmychute

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Wheresmychute
I've been losing some weight in an attempt to get healthy, but will probably have to address the elephant in the room which is gynecomastia sometime soon. It can be a fairly expensive procedure, but I was reading that insurance will sometimes cover it when told it causes "mental distress" or some such. Mine is fairly severe so I think I can use that excuse, even though it's not really that distressing.

However, I am already knee deep in dealing with the FAA due to using SSRI's, so I don't want any sort of "mental distress" to complicate that issue, and would rather pay out of pocket if it means keeping the FAA off my back.
So for any familiar with this who could lend some advice I would really appreciate it.

I also wonder if the "mental distress" could be linked to the SSRI, so I could 'solve' my anxiety issue by getting Gynecomastia surgery, and make it easier to get a first class medical. Theoretically.

tl:dr - Want to get gyno surgery and use insurance to cover it for "mental distress" but would rather not cause any more trouble with the FAA, looking for answers.

Thanks for any advice.
 
If you need treatment for your health, do it.

Of course you'll have to report the treatment to the FAA either way, but you know a mental health diagnosis will complicate things. So it would be an exceedingly bad idea to seek out a MH diagnosis for a condition you didn't have just to get insurance to pay. (It's insurance fraud along with the FAA issues.) But if you are suffering from mental distress, not getting diagnosed and treated for that isn't helping.

And if it's true gynecomastia, then the FAA will want to know the cause, which might require additional inquiry.

And some SSRIs can cause gynecomastia. Have you discussed this with your treating physician?

The bottom line is take care of your mental and physical health as the priority, FAA medical second.
 
Lindberg said:
If you need treatment for your health, do it.

Of course you'll have to report the treatment to the FAA either way, but you know a mental health diagnosis will complicate things. So it would be an exceedingly bad idea to seek out a MH diagnosis for a condition you didn't have just to get insurance to pay. (It's insurance fraud along with the FAA issues.) But if you are suffering from mental distress, not getting diagnosed and treated for that isn't helping.

And if it's true gynecomastia, then the FAA will want to know the cause, which might require additional inquiry.

And some SSRIs can cause gynecomastia. Have you discussed this with your treating physician?

The bottom line is take care of your mental and physical health as the priority, FAA medical second.
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It's true. I've had it since I was a kid for growing up overweight. It's not causing any significant issues other than aesthetic ones. I was just weighing my options, it is a 6k to 10k surgery so getting insurance to pay for it would be a huge boon. But as you say, I would not trade a diagnosis for it.
 
Question said:
Have you asked about if TRT would help the Gynecomastia? The FAA allows TRT
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No, while I would love to have a medically sound reason to go on TRT, from what I've read the actual breast tissue can only be removed with surgery. I will look into it though.
 
The insurance spec for "mental distress" will not involve any forma evaluation for same; this is rarely a problem FAA wise.....
 
Wheresmychute said:
No, while I would love to have a medically sound reason to go on TRT, from what I've read the actual breast tissue can only be removed with surgery. I will look into it though.
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I have relatively high testosterone (~700) and bilateral gynecomastia (which presents much worse after losing 30 lbs!)
At 68, it's not something I'll bother with.
 
FWIW as a physican, I can tell you that "mental distress" alone generally will not get your insurance company to approve this. It has to be causing some functional limitation, or other medical problem. For example the gynecomastia is so severe that you get documented recurrent skin breakdown and infections.
Otherwise, everyone would claim "mental distress" to get the shape of their nose fixed, non cancer moles removed, etc.
 
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