Would insurance likely pay for a breast reduction?

Q:

With a weight of 160 and height of 5'7" and a bra size of 34G, would insurance likely pay?

A:

It certainly sounds like you are a good candidate for a Breast Reduction. Understand that Insurance Company’s dictate covered services or health care not physicians with our current health care system. Consider calling your insurance carrier to see if Breast Reductions are a covered service. Then, request what requirements must be meet for you to qualify for the procedure such as treatment for neck/ back pain, treatment for rashes under the breasts or shoulder grooving & arthralgia. Also,vask you carrier for a list of Plastic Surgeons in your area that accept their plan. Lastly, compare their list to ASAPS members in your area. Our Members are experts in Breast Surgery. Best,

 

Gary R Culbertson, MD, FACS

A:

Probably.  In our area, most insurance companies will pay (after a prior approval process) when women have long term symptoms of back, neck and shoulder pain, which haven't resolved with prior non-surgical treatment, DD or larger breasts, and your surgeon plans significantly large removal of excess breast tissue (you'll need an in-person evaluation for that assessment, and additional important information).  I just recently posted a blog on this subject. http://www.expertplasticsurgeon.com/blog/2014/06/03/breast-reduction-insurance-company-requirements-145072

A:

Yes, I certainly think you are a great candidate.   You should look at your insurance coverage and the rules and regulation for breast reduction surgery.  You need to find a Plastic surgeon on your insurance plan that you would like to work with.  Good luck.

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