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At age 30. weighing 140 pounds (small frame) and a size 34 G bust - will insurance pay for a breast reduction for me?

Q:

I know I am a good candidate for breast reduction.  At age 30 years old and having 2 kids, my breasts are size 34 G.  They cripple me emotionally and physically.  I have always had large breasts but now they are ridiculous and saggy.  I am small framed as well.  My surgeon said he has to "work" to convince my insurance company that I am a good candidate for breast reduction.  Shouldn't I already be approved for insurance coverage for this surgery given my circumstances?

A:

Breast reduction is something that can be either cosmetic or reconstructive. Because of this, insurance companies make their requirements quite strict. The fact that your doctor is working to get you approved is good. Not all physician offices will do this any longer. You may have to write and call also in order to get the approval. To answer your question, no approval for this is automatic no matter what your circumstances.

R.T. Buchanan, MD

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