Lipedema Diagnosis, MLD, and Health Insurances

Manual lymph drainage massage denied

So Monday, an envelope from my insurance company was laying in wait for me.  Not surprising since I’ve recently started the manual lymph drainage massages and will be getting compression stockings in a few weeks as well.

However, what I wasn’t really prepared for was what this letter said.  In a nushell it’s saying that the MLD is being denied.

Awesome, especially since what you see is all I got.  No explanation as why they’re denying this (especially since it’s clear it’s working, the tape measure don’t lie) or anything.

So on Tuesday my husband calls up the insurance and asks about the denial.  Apparently the way he explained it, that it’s for lymphedema, the person on the other line said that the clinic where I’m getting the MLD doesn’t even have to ask permission.  They just need to send in the bill because I get 20 sessions a year before my basic insurance takes over.  Okay…

Brief explanation about Dutch healthcare…it’s not free like everyone thinks…

Unlike Denmark and Sweden, which still have nearly 100% socialized medicine, the Netherlands decided to privatize health care about 10 or 12 years ago. On a scale of 1 being the worst thing the Netherlands has done and 10 being the best, I’m rating going private with healthcare a -100.  It doesn’t work, we all just need to look at the USA for that lesson.

So what it comes down to is everyone pays for a basic health care package through AN insurance provider.  There’s several you can choose from and some offer things in their basic packages that others don’t.  However, all of them give you the right to seeing your huisart (GP/family doctor), x physical/psychological therapy sessions a year, certain medications, and things like the compression stockings and inlays for your shoes.  There’s more, but that’s a good gist.

Now, as I said EVERYONE has to pay for this basic health care package by law.  You can get fined something fierce for not having health insurance of some type, every resident MUST have it.  No ifs, ands or buts.  If you’re on bijstand (welfare), can’t work due to a disability, and a few other situations, you can get reduced costs on the basic package or for some people it can even be free.

Then, if you wish, you can buy extra packages on top of the basic.  Because I’ve always been heavy and knowing the increased risks of my weight, we’ve always gotten some pretty hefty insurance for me since we knew at some point my luck would run out.  Either I’d start developing weight related complications or I’d finally run into a diagnosis that explains everything.

There wasn’t anything wrong with my ridiculously expensive insurance…it was the diagnosis

Anyways, yesterday after calls to the clinic and the insurance company (plus some letters with copies of my diagnosis came in from the insurance which explained a little more about why they’re denying me) we finally figured it out.

My Lipedema Diagnosis It’s because the student dermatologist wrote down for the purpose of the MLD and compression stockings that I had chronic lipedema, not LYMPHEDEMA.  If she’d have written down chronic or secondary lymphedema (which I do have the beginnings of) we wouldn’t have spent all week playing phone tag with our insurance company or in fear that the expensive treatments and stockings wouldn’t be covered.

Apparently, even though lipedema IS recognized in the medical community waaay more than in the US, and a lipedema diagnosis is much more common here than in the US, there still isn’t a set in stone treatment for it in order to satisfy the for profit institution of health insurance.

What this means is I’ve now got to go back to the dermatology department and ask them to write out a new diagnosis and send it over so we can give that to the clinic and then they can send their bills to the insurance company.

Who knew a few letters would cause all sorts of stress and chaos?

PetraAnn

PetraAnn was first diagnosed with Lipedema in fall 2015 after years of eating keto and exercising with no weight loss results.After diagnosis, she has gone through 8 tumescent liposuction procedures from 2016 until 2018 and on 17 December 2019 underwent an abdominoplasty to remove the remaining 3-4 liters of lippy fat and loose skin.
PetraAnn

Latest posts by PetraAnn (see all)

Leave a Reply

Your email address will not be published. Required fields are marked *