Breast reduction increasingly not covered by insurance

Peter E. Johnson, MD answers: How much does breast reduction cost?

I am quite sure my insurance plan cant cover the cost of breast reduction surgery. They don't consider it a medical necessity even though my breasts are causing me severe back pain and neck aches. About how much is a great plastic surgeon going to charge for a breast reduction? Does this include anesthesia too?  Warm thank you for helping me


Peter E. Johnson, MD
9 months ago

I am sorry to hear the insurance benefits that you have do not cover breast reduction surgery. In the Chicago area where I practice this has been a trend for some time now. Despite the proven benefits of less back strain and postural backache and improved ability to exercise most of the PPO plans in our area will no longer provide coverage for this very beneficial procedure. Even Blue Cross plans in Illinois send our patients a list of 15 criteria they must meet in order to qualify. They must meet all 15, one of which requires a year of physical therapy, another strict weight requirements. Interestingly many of our HMO plans will still provide coverage.

This push by insurance to deny coverage in most cases has induced many surgeons to improve how they approach the procedure. It must be affordable and in Chicago the total cost is around $7500. This will include everything necessary, surgeon, facility, anesthesia, bras, and aftercare.

Hospital costs are very high and our practice uses an office based accredited facility. Surgery usually involves a newer short scar technique, and of course there is no overnight hospital stay. We do not use any tubes or drains and this allows showering and full activity from the start. Recovery is about a week. I have adopted this routine for the past seven years and patients have been very happy with it.  I hope you can find a surgeon in your area as well who can make reduction affordable to you.

Best of  luck.

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A: Breast reduction costs $8000-12,000 for the total package

David A. Dreyfuss, MD
9 months ago

Breast Reduction surgery is very commonly not covered by insurance.  They have totally unrealistic expectations for removal of tissue.  Because of this fact, most offices have created a package price for non-covered reductions.

The common prices for surgery, anesthesia and facility range from $8000-12,000.  The package includes all post op visits.  Seek our a Board Certified Plastic Surgeon in your area thru Plasticsurgery.org.  There are many qualified doctors in your area.

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