Worried I'm not going to be considered "big enough" to qualify

  • Laura43546
  • 2 years ago

I've just discovered these forums as I have started to consider the BR surgery, and certainly there is lots of useful info on here!   I'm currently a 36DDD/36F (as measured by my local bra fitting shop) and I've been getting worsening back, neck and overall posture issues the past year.  I've been heavy-chested for a while, but since having kids, I went from a 36D to a DDD.  I'm 5'5 and 142.   I am definitely over it, and I can't stand looking at pictures of myself with any sort of fitted shirt because all you see are boobs!  I'm done having kids, and this really runs in my family - my mom & her sisters are big.  One had a reduction and her biggest regret was waiting so long to ask for it.  My mom's doctor is on her case to get it done as well.   I've been seeing a chiropractor, and I have scheduled an appt with a plastic surgeon in a couple of weeks (I don't need a referral with my UHC insurance).  However, I'm worried they are going to say I am not big enough to qualify for insurance to cover?   How does the surgeon measure you to determine your "real" size?  I mean, bra size is probably relatively meaningless in the end, since so many people wear the wrong size, different manufacturers mean different sizes, etc.     Just trying to prepare myself!

Comments (2)

I just had mine done last week and it was covered by insurance (minus my deductible). I would first go under your plan and find out if indeed, they will cover BR surgery. Some health plans won't do it at all. Some PS don't accept some insurance either. If you have a few reputable PS in mind, find out if they accept your insurance. Find out what your out-of-network deductible will be as well in case the PS you want isn't in-network. Many insurance companies want you to do conservative options first, like a Chiro or PT (which you're doing) and some may want you to lose weight. If your insurance covers BR, you will need precertification and it is based on your bust size, height, weight, medical necessity. There is a certain amount that MUST be removed for insurance coverage. I believe 500 grams (454 grams is a pound), it could be more or less depending on the insurance. I was a 38DD/E and my PS told me he took about a pound off per side. I wanted to be a C or smaller. Right now, with all the swelling, I'm a full D but its only been week. I actually looked smaller 2 days after surgery than I do right now. Btw, is UHC United Healthcare? If so, my insurance is United Healthcare Oxford. I believe my BR surgery criteria falls under the United Healthcare umbrella. Hope this helps and good luck!
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Most insurance companies require a certain amount of tissue to be removed (in grams). The PS will be better able to discuss that with you as all insurance plans have varying criteria. I self-paid because my insurance plan most likely wouldn't cover for various reasons and I was tired of the hassle and pain. Good luck.
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