Typically insurances cover procedures that improve function or relieve pain or other medical issues. Reconstructive surgery is viewed as making something abnormal appear more normal. Cosmetic surgery is viewed as enhancing something that appears normal. Obviously insurance companies vary widely in how they interpret those definitions. If you have significant breast asymmetry, they will be unlikely to pay for augmentation. They may pay for a reduction of the larger breast if it is causing postural problems and back and neck pain due to the imbalance on your chest. First decide along with your plastic surgeon what procedure will benefit you the most. Then consider insurance coverage is appropriate. Don't let insurance coverage dictate the best procedure for you.
Insurance coverage for breast asymmetry
Bahram Ghaderi, MD answers: Getting insurance to pay for augmentation of massively asymmetrical breasts
I'm not sure if this is the correct website for this question, but I was wondering how to get insurance to pay for some or all of the cost of breast augmentation surgery to correct massively asymmetrical breasts. My right breast is a large C-cup, possibly D, and my left breast is a small B-cup, possibly A. A visited a plastic surgeon who recommended breast augmentation surgery, but my insurance company will only pay for reconstructive cosmetic surgery. Thank you for your advice.
A: Congenital and asymmetric breasts
SEE VIDEO FOR EXAMPLES:
It is highly unlikely that any insurance complan y will pay for placement of an implant for management of a congenital breast asymmetry in my experience.
In some instances, they may perhaps be willing to reimburse a portion of performing a reduction on the larger side (D down to a B) but you would need to request that your plastic surgeon draft a letter with photographs to support your claim. It is not unusual for plastic surgeons to charge for this process.
Contact the doctor
