Ive been having problems with my breast all of my life. I have gone to physical therapy for back, neck & shoulder pain and it never helps. I feel as if the last option is surgery. I have intended bra strap marks and horrible posture because of it. I have UnitedHealth Care. Can I be a good candidate for this surgery ?
19, 5'1, 130lbs 36DD Want to Get Breast Reduction?
Doctor Answers (6)
Breast reduction candidate
Will United cover your reduction?
Every insurance plan has their own unique criteria on whether they will cover a breast reduction. More and more, we are seeing plans where a breast reduction is not a covered benefit. If it is a covered benefit, some insurance plans set a minimum required amount of tissue to be remove in order to met their threshold for coverage. Some set the amount in relation to your BMI (height and weight). Others require extensive medical records documenting neck pain, back pain, and history of rashes. The other alternative is to opt for a breast reduction as a self-pay option. Start by visiting with a board certified plastic surgeon to learn more about your options.
Insurance and Breast Reduction
Based on your measurements you seem to need, and be a great candidate for a breast reduction. Getting breast reduction covered under insurance is very difficult. In fact getting them to tell you, as the consumer, the number of grams needed to get coverage will be nearly impossible. I suspect in the end it will have to be paid out of pocket. The insurance frequently places the restrictions and makes it difficult without any medical substantiation. I have had many difficulties with my own patients (who truly needed it) getting coverage. The best way to get coverage is to call your insurance company...remember you are the consumer.
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Candidate for Breast Reduction Surgery
Your first step, as with any plastic surgery procedure needs to be an in-person consultation with a board-certified plastic surgeon. If possible, choose a surgeon that specializes in breast reduction surgery. Many patients are very happy with the results of their breast reduction. They look better, feel better, and have great relief from the kind of back and neck pain you described. Since breast reductions can traditionally result in much scarring, do some research on short-scar breast reductions, also referred to as the lollipop incision, which is our specialty. Generally use of the short-scar breast reduction technique gives the patient a short recovery time in addition to less scarring than other breast reduction methods. Good luck and I hope this helps!
Breast Reduction Candidate?
Based on your description, you may be an excellent candidate for breast reduction surgery.This operation tends to be one of the most patient pleasing operations plastic surgeons perform.
As you think about breast reduction surgery make sure you do your homework and understand the potential risks and complications associated with the procedure. Unsatisfactory scarring is one of the potential complications. Make sure you also understands that further surgery may be necessary in the future (for example if the breasts were to grow in size again).
The best way to obtain insurance coverage for breast reduction surgery involves some “hoops” to jump through. The more documentation you have (for example, from your primary care doctor, physical therapist, chiropractor etc.) the better when it comes to obtaining insurance “authorization” for the procedure.
This documentation and letter/pictures from your plastic surgeon will help you obtain authorization.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.