Getting Insurance to Pay for Augmentation of Massively Asymmetrical Breasts

asked 2 years ago by dolphinsfan in US
Latest answer by Kris M. Reddy, MD, FACS
Question viewed 1,172 times
Tags: breasts, asymmetry, costs, insurance

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.

7 answers to Getting Insurance to Pay for Augmentation of Massively Asymmetrical Breasts

Breast Asymmetry and Insurance

Breast asymmetry correction is generally considered to be a cosmetic procedure. Insurance would typically not cover the procedure.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon

Insurance to cover breast asymmetry

In general insurance companies do not cover the correction of breast asymmetry. You might be able to get them to cover a unilateral breast reduction, but they will not cover augmentation. If you wanted to pursue a reduction, your plastic surgeon's office could advise you how to proceed. The patient usually needs to submit verification that the large breast is causing symptoms such as back pain. If you want to pursue this, ask your plastic surgeon who in his/her office helps with getting... more

Tracy Pfeifer, MD
Manhattan Plastic Surgeon

drpfeifer.com

Breast augmentation and symmetry correction won't be covered by insurance

Unfortunately, serious asymmetry is still something you can survive and live with and as such, your insurance won't be willing to provide coverage. Try to save for the necessary procedure to improve the situation but don't place your hope on getting coverage as it will just leave you frustrated.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Breast augmentation insurance coverage

I do not know of any insurance companies that will pay for breast augmentation surgery. They may cover a breast deformity it a young adult who has Poland's syndrome or maybe a tuberous deformity. But most won't.

Steven Wallach, MD
Manhattan Plastic Surgeon

Augmentation for Asymmetric Breasts

Insurance companies will sometimes cover a unilateral augmentation when there is very significant asymmetry. They may consider it a birth defect, which in fact it is. There is no way to know without asking. Ask your plastic surgeon to write your insurance company to see if they will cover the procedure; then you will know for sure.

John Whitt, MD
Louisville Plastic Surgeon

Insurance coverage for breast asymmetry

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... more

Bahram Ghaderi, MD
Chicago Plastic Surgeon

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.... more

Otto Joseph Placik, MD
Chicago Plastic Surgeon

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