Insurance Carriers dictate Health Care today not physicians since, they are paying for the services you receive. Insurance plans are like cars. Some are Dodge Metro’s designed just to get you from A to B while others are Fords. The Cadillac plans are becoming very rare. If you have an inexpensive plan Breast Reductions may not be easily covered or not covered at all.
May I suggest you first consider upgrading or changing your insurance plan for better coverage. If this is not possible then, pursue your insurance carriers requirements for you to have a breast reduction through your primary care physician or Gynecologist. Complete all their requests and if you are denied your surgery request why. Be aware that some insurance plans make their clients jump through some incredible hoops to even be considered for a Breast Reductions to be covered. While other plans are less restrictive. Again, it is often related to the expense of the plan.
Asking your surgeon to “Push” an insurance carrier is not a wise move. This is your insurance plan and you are the best advocate. Surgeons are merely service providers that can easily be replaced in todays Health Care Marketplace. A better option may be to consider having your Breast Reduction done as a Cosmetic procedure. Your overall out of pocket expenses could be less depending upon your co-pay’s, deductibles, non covered sevices, etc.? Hope this is of assistance. Best,
Gary R Culbertson, MD, FACS