I'm 27 Years Old and Stand at 5'6 1/2 and Weigh 256 Pounds. My Cup Size is 42 M. Would my Insurance Pay for a Reduction?

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5 Doctor Answers | Asked by whelena1984

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Insurance Coverage for Breast Reduction

Based on your dimensions you appear to be a candidate for breast reduction surgery. If your primary care physician provides documentation and treatment of your symptoms arising from your breast hypertrophy, you should be able to have insurance pay for breast reduction surgery. Sometimes, however, insurance may deny coverage if it thinks that weight loss alone can reduce the size of your breasts. If you are approved by insurance, you could then be evaluated by a plastic surgeon for surgical... more

New alternative with no vertical scar is The Ultimate Breast Reduction

Insurance companies pay for breast reductions when you meet 2 criteria. First, you have to have symptoms related to the large breasts such as neck, back and shoulder pain or rashes. Second, you must have weight removed that meets their criteria. Their weight criteria is determined by your height and weight, which determines your body surface area. At 5'6 1/2 and 256 lbs, your body surface area is 2.3 meters squared. If your insurance was Aetna, they would... more

Breast reduction coverage

Breast reduction is usually covered by insurance when the surgery is performed as part of a medically mandated procedure to treat neck, back, or shoulder pain or other problems related to the spine. Recently, managed care has adopted stricter standards for coverage, so just make sure these problems are thoroughly documented in writing by your primary care physician and plastic surgeon. They may also have to submit photographs. Even then, you may be required to seek a second opinion from a... more

Insurance should cover breast reduction

Insurance coverage for breast reduction has become more difficult, even though plastic surgeons have show improvement in discomfort and improvement in function after surgery. Each insurance plan will differ, and the process starts with a letter of predetermination to see if your particular plan will offer coverage.

Breast Reduction and Insurance Coverage?

Based on your description you may be an excellent candidate for breast reduction surgery at some point; it will be in your best interests to drop weight first. Doing so will help decrease the risks of surgery and help minimize the chances that additional surgery will be come necessary in the event of weight loss that occurs after the breast reduction procedure. The best way to obtain insurance coverage for breast reduction surgery involves some “hoops” to jump through.... more