Breast Reduction Q&A

95%

WORTH IT RATING

448 Reviews

Ask a Question

View Before and Afters

Average Breast Reduction Cost: $4,600

Learn about Breast Reduction

1,806 people and 560 doctors are talking about Breast Reduction

Get Free Email Updates

I Am About 5"8 and Weigh 180. My Breast Size is a DDD or G. Will Insurance Pay for Reduction?

asked 5 months ago by shinedown6 in Plano, TX
Latest answer by Alan Engler, MD
Question viewed 136 times
Tags: Blue Cross/Blue Shield, coverage, DDD cup, insurance

I have Blue Cross and need to know if it likely that they would say I have enough tissue that could be taken out for them to cover this as a medical problem

7 answers to I Am About 5"8 and Weigh 180. My Breast Size is a DDD or G. Will Insurance Pay for Reduction?

Breast Reduction - Insurance Coverage

Maybe. There are many issues with respect to insurance. Each insurance company is different, and each has its own rules with respect to "coverage." You'll first have to contact your company to make sure it's covered, and then you have to find a surgeon who will accept the payment the insurance company says is "usual and customary." That may or may not be easy to do. If you start with the surgeons who participate in the insurance company... more

Alan Engler, MD
New York Plastic Surgeon

Insurance will pay for breast reduction surgery, but must meet requirements

Document, document, document! Insurance companies will pay for a breast reduction IF the woman has neck, back, shoulder or breast pain, or rashes or macerations that require medical treatment. They determine the amount to be remove based on body surface area. You would have to contact BCBS for their requirements. The disadvantage of having your insurance company pay for the procedure is meeting their weight requirements. For example, if the weight requirements were... more

Gary M. Horndeski, MD
Houston Plastic Surgeon

www.horndeski.com

Insurance will require specific symptoms AND removal of at least 606 grams per breast (1 1/3 lbs. each)!

As a reviewer for Blue Cross/Blue Shield for many years, I can tell you that your surgeon will need to document back pain, neck pain, shoulder grooves from bra straps, rashes (intertrigo) beneath your breasts, and perhaps even numbness in your 4th and 5th fingers from bra strap pressure on the nerves to these fingers (in your lower neck/shoulder area). This list is subjective and virtually every breast reduction patient with large breasts has all if not most of these symptoms to some... more

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon

Breast Reduction Insurance

Insurance may cover breast reduction for some women. It depends on the patient’s breast size, body type, and symptoms. Most insurance companies have a formula based on your height, your weight, and how much your surgeon estimates will be removed. Usually removal of about a pound from each breast is required for insurance coverage. Health care providers are mercenary about denying coverage for breast reduction. They don’t care if your clothes don’t fit or you... more

Joe Gryskiewicz, MD
Minneapolis Plastic Surgeon

Blue Cross Blue Shield May Cover Breast Reduction Surgery

You are most likely a good candidate for breast reduction surgery. Getting insurance to cover it is another matter. Most insurance companies have several different types of policies so it is possible some Blue Cross policies will cover while other may not. You should see a Board Certified Plastic Surgeon who can tell you if you would qualify and then would help you get preauthorization.Good luck! see video

Miguel Delgado, Jr., MD
San Francisco Plastic Surgeon

www.dr-delgado.com

Will Insurance Pay for Breast Reduction

You should be able to be considered for a breast reduction if you meet certain criteria. Call a Board Certified plastic surgeon or get a referral from your primary care doctor. You may want to ask the surgeon's office ahead of time if there is anything else they would like you to bring (insurance information, name of primary care physician). For breast reduction surgery, it would be good to find out what criteria your insurance company requires to approve the surgery and have it... more

Karol A. Gutowski, MD
Chicago Plastic Surgeon

Breasts Reduction and Insurance Coverage?

Based on your description you may be a good candidate for breast reduction surgery; it is one of the most patient pleasing operations we perform. If you are not there you may want to reach a long-term stable weight prior to surgery. 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... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

Ask a question