No Rhyme or Reason

Kenneth R. Francis, MD answers: Will insurance cover revision for uneven Breast reduction results?

I had a Breast reduction done many years ago and have very painful scar tissue as a result of it. My breasts are also 2 VERY different sizes where do you find a bra with a B cup and a C cup : (

Will my insurance pay for this disaster to be corrected?


Kenneth R. Francis, MD
5 months ago

Mkw,

Unfortunately, there is almost no rhyme or reason as to what insurance carriers will or will not cover.  It depends on what state you are in, what insurance carrier you have, what your specific plan is and sometimes who picks up the phone when you call for authorization.  It's that ridiculous.  A letter from your surgeon would document your symptoms and the medical necessity for surgery.  Sometimes photos of your condition are helpful for the insurance company to appreciate the cause of those symptoms.  I would recommend a visit to a board certified plastic surgeon for some assistance and guidance as to how to get approval.  Good luck!

A: Insurance coverage after previous reduction

Barry H. Dolich, MD
5 months ago

They MIGHT. A strong letter by your surgeon , accompanied by photos,emphasizing the functional aspects of your situation is the place to start. Focusing on the scar revision can help gain approval.

A: Insurance to cover breast revision surgery?

Steven Wallach, MD
5 months ago

It is difficult to tell you whether or not your insurance company will pay for revision surgery of your asymmetry.  They may pay for scar revision if  your scars are truly painful and enlarged.

A: It all depends on your insurance.

David Shafer, MD
5 months ago

 It really depends on your insurance policy, however, if it is a complication from a previously covered surgery, then you may have a good chance for coverage.  You will likely need to see the surgeon and have them write a letter to your insurance company to get pre-authorization for the procedure.  Good luck.

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