Breast Reduction Coverage by Medicaid Possible?

asked 2 years ago by Kayla08 in Illinois
Latest answer by Tom J. Pousti, MD
Question viewed 1,099 times
Tags: age 18-24, breasts, female, 110-129 lbs, 5 ft 0 in to 5 ft 3 in, C cup, insurance

I am a 19 year old single mother. I am 5 foot 1, and weigh 113 pounds. My breasts are a 34DD. Since I entered middle school my breasts have been abnormally large for my frame. In 6th grade I was in a C cup. Would Medicaid cover my breast reduction? And if so, how do I go about this process?

7 answers to Breast Reduction Coverage by Medicaid Possible?

Breast Reduction and Medicaid?

Thank you for the question and picture. Yes, I think you may be an excellent candidate for breast reduction surgery. I think the biggest challenge you will have is finding a reputable plastic surgeon who works with Medicaid. Best wishes.

Tom J. Pousti, MD
San Diego Plastic Surgeon

Ins

Each insurance company has different criteria for pre-approval of a breast reduction surgery and you should contact your carrier. Check with Medicaid.

Steven Wallach, MD
Manhattan Plastic Surgeon

Insurance coverage for breast reduction.

Hi. I wrote a long article about insurance coverage for breast reduction for RealSelf. Please read it at the bottom of my RealSelf profile. I think it will help you.

George J. Beraka, MD
Manhattan Plastic Surgeon

Medicaid Breast Reduction

You will be hard pressed to find a plastic surgeon that accepts medicaid for breast reduction. First it will have to be authorized. Even if approved, the reimbursements are so low that it does not cover the time and the expense of the plastic surgeon, so most would not do it. Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon

Medicaid coverage of breast reduction

First you need to find a plastic surgeon who accepts medicaid and have a consultation. They will help guide you through the precertification process.

John P. Stratis, MD
Harrisburg Plastic Surgeon

Breast reduction under medicaid

I would agree with Dr. Rand's summary. Breast reduciton may be a covered procedure given your symptoms but the amount of reimbursement is inadequate to cover the vast majoirty of plastic surgeons overhead expenses. Most surgeons cannot run their practices and continue to work based on the payments made by medicaid. Training programs may be able to provide you with relief from your symptoms and surgery will be performed under the guidance

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Breast reduction by Medicaid

Unfortunately, the reimbursement from Medicaid to the doctor for doing a breast reduction is less that the cost to the doctor to do the surgery in most cases so you won't find many practicing plastic surgeons who will take Medicaid. However, there are some fine training programs in Chicago where plastic surgery residents can evaluate you and probably perform your surgery under the guidance of a professor. Having run one of these programs for 10 years, we did breast reductions on... more

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Ask a question

Get Free Email Updates