Will Insurance Allow Breast Reduction from F to D Cup?

Thank you for your question.
You may be a candidate for breast reduction surgery. Contact your insurance company for the requirements/criteria to have this surgery approved. Schedule a consultation with a board certified plastic surgeon to discuss your options. Best wishes!

#Breastreduction : size and insuranceIn general when the #excessivebreastsize causes functional problems, insurance will generally pay
for the operation if more than 400 – 500 grams are removed from each breast
dependent on your individual insurance company requirements.

Hello! Thank you for your question.  It is a safe procedure, in which your plastic surgeon will reduce the amount of breast tissue, reshape your breasts, raise the nipple-areolar complex to its appropriate position (possibly making the size smaller, if needed), and ultimately ameliorate the possible complaints that you do have for the reason that you are having this procedure (e.g., neck/back pain, migraines, rashes/infections, shoulder grooving, etc).  Your complaints certainly sound as if you would be the ideal candidate for a breast reduction.  Cup size alone is not mandatory, but sometimes the amount of tissue removed - enough should be excised to ameliorate your complaints.It would be in your best interest to have a mammogram prior to the procedure for screening prior to this procedure, as the architecture imaging of your breast will slightly change afterwards. Well known data exists that having a breast reduction will in fact lower your chance for developing breast cancer, simply because the amount of tissue will be less.Consult with a board-certified plastic surgeon who will discuss the procedure with you, examine, and assist you in determining if this is the right procedure for you.  Voice your complaints - your insurance will likely require a detailed description of your history and complaints as well as photo and an estimate of how much tissue will be removed.  You should give a description of the therapies that you have done to ameliorate your complaints thus far.  Any other notes from other physicians is helpful.  It would also behoove you to discuss your issues yourself with your insurance carrier.  Hope that this helps!  Best wishes!

I find that there is a large amount of variability in breast size when patients say they wear an F-size bra.  It is best for you to consult with an expert plastic surgeon to accurately estimate the weight that you will remove with breast reduction surgery.

Although you appear to be an excellent candidate for breast reduction, whether your insurance will pay for it depends entirely on your plan. Insurance coverage varies between companies, and even between different plans in the same company. Generally, however, most plans will cover breast reduction if the following criteria exist:
1) Back pain (from breasts being too big)
2) Bra strap grooving on the shoulders.
3) Rash in the lower breast fold that does not respond to medical treatment.
4) Your surgeon believes that a minimum amount of tissue can be removed (usually 500 gms per side, sometime less)