What to Do for Insurance Coverage for Tummy Tuck and Breast Reduction?

Many insurances will not cover a D cup reduction. Others require documentation of conservative medical management including physical therapy. Abdominoplasty is generally not covered without documented medical reasons to support the request. Psychiatric distress has not been grounds for insurance coverage for many years.

As already mentioned, insurance will not cover cosmetic procedures.  As with anything, if you feel that it will help you, I suggest saving up and paying for the procedure.  It may sound expensive (and it may be) but it will have a great beneficial effect on a person.   The rewards are great.

80% of breast reduction questions on RealSelf are about insurance coverage. Here are some helpful points. 1) Insurance companies try very hard not to pay for breast reduction, even though they should. Even small breast reductions relieve many symptoms such as back pain and shoulder pain, and even some types of headaches. 2) Very big reductions (like from an F cup to a C cup) will usually be covered. 3) Many policies will pay for breast reduction if 500 grams (a little more than a pound)... more

As you have learned, there is no insurance, nor should there be, for cosmetic surgery. Insurance money needs to go toward covering medically necessary care. Please consider going to Johns Hopkins in Baltimore and see if they have a "plastic surgery resident's clinic" where you can have cosmetic surgery at dramatically reduced prices. Good luck!

Medicaid IS NOT insurance, as we know it. It is a small selection of ESSENTIAL to your health, hard to obtain, poorly paying medical services which looks like will get worse because of the poor economy and the States' tax money shortage. A Tummy Tuck (Abdominoplasty) is an extensive cosmetic surgery which involves relocation the belly button, tightening the tummy muscles and removing loose skin. It is never paid for by real insurance company, much less so by Medicaid. In rare cases, some... more

Kim, Many insurance plans will pay for certain operations for body contouring when medically necessary, such as: 1) BREAST REDUCTION 2) PANNICULECTOMY (removal of excess abdominal skin) 3) HERNIA REPAIR Most PPO, and POS plans and even Medicare will cover some of these operations. However, every insurance company has different requirements before they will cover them. You should check with your insurance company and even consider upgrading to a different insurance company or insurance plan.... more

Dear Kim These are questions I am asked frequently. Unfortunately the answer I will give you will not make you happy. As far as breast reduction goes you need to show several things. First you have tried non-surgical methods to control your symptoms. And you must have documented symptoms of back pain, neck pain bra strap grooving and intertrigo as documented by your primary care doctor or chiropractor. Then you must be within a "normal weight for your height and finally depending... more