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Am I a Good Candidate for Breast Reduction with my Insurance

asked 11 months ago by marie386 in West Palm Beach, FL
Latest answer by Fredrick A. Valauri, MD
Question viewed 346 times
Tags: candidate, D cup, insurance, posture, shoulder pain

I am currently 24 years old 111-114lbs and wear a D cup or DD if the brand runs small. I try to exercise by doing something low impact such as pilates and find myself in pain at the end of the work out. My posture has gotten worse and I slouch. My back shoulders and neck hurt on a daily basis and find myself wanting to sit down because of the back pain. I'm not really sure what to do.

12 answers to Am I a Good Candidate for Breast Reduction with my Insurance

Insurance Coverage and Breast Reduction

Insurance coverage of breast reduction surgeriess is more difficult to obtain than before. Some policies don't even cover breast reduction surgeries, while those that do have a number of requirements. In addition to large breast size, you must have neck or back pain that has not responded to physical therapy, and have a insurance mandated minimum amount of anticipated breast tissue removal. Based on the information, your provided you probably will be covered,... more

Fredrick A. Valauri, MD
New York Plastic Surgeon

www.drvalauri.com

Breast Reduction Candidate?

Thank you for the question. Based on your description you may be an excellent candidate for breast reduction surgery. It is one of the most patient pleasing operations we perform. Your first step may be to visit with a few well experienced board-certified plastic surgeons to discuss your situation. Educate yourself about the operation, the benefits as well as the risks/ complications of the procedure. Timing of the operation ( with regards to psychosocial situation and/or... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

Candidate for reduction

It sounds as thouhg you may be a candidate for a reduction since you are os active and large breasts can get in the way.wheter insurance will pay is possible after your photosand report from the plastic surgeon are sent to your insurance carrier to see if they would pay.

Robert Brueck, MD
Fort Myers Plastic Surgeon

www.beauty-by-brueck.com

Insurance Coverage of Breast Reduction

There is no standard among insurance companies for the coverage of breast reduction (except for always attempting to avoid covering this procedure) and, in fact, some insurance policies have an outright exclusion for reductions and will not cover them under any circumstances. With your small frame, cup size, and symptoms your surgery should be covered unless your policy contains the exclusion.

John Whitt, MD
Louisville Plastic Surgeon

Breast Reduction - Will I Get Relief With A Small Reduction, and Will It Be Covered by Insurance?

Hi marie386, There are two issues here: (1) Would you benefit from a breast lift or reduction and (2) Will your procedure be "covered" by insurance. For a full and complete answer you would, of course, have to be assessed by someone who can talk to you and examine you in person, but here are a few thoughts. With respect to (1), even a small reduction (basically a breast lift, since removing less than about 10 ounces of tissue from each side is generally considered a... more

Alan Engler, MD
New York Plastic Surgeon

Breast Reduction and Insurance

Every insurance company is different, so you really need to check your own policy and discuss your options with a plastic surgeon in your insurance network. They would be the best to know if you may qualify or not under your plan. Good Luck.

David Shafer, MD
New York Plastic Surgeon

Breast Reduction and Insurance

Each insurance company has their own criteria to determine if a breast reduction will be covered. Then many insurance companies have different policies within their own company. You need to check with your insurance company and find out if a breast reduction is even covered under the policy you have. If it is, I would then recommend that you have a consultation with a Board Certified Plastic Surgeon (even two or three until you find one you are comfortable with). Your plastic surgeon will be... more

Miguel Delgado, Jr., MD
San Francisco Plastic Surgeon

www.dr-delgado.com

Am I a Good Candidate for Breast Reduction ?

You SOUND like you would benefit from a Breast Reduction but this does not mean that YOUR insurance company would approve the surgery. The first thing you need to do is find out if your particular policy pays / covers Breast Reduction Surgery. If you do NOT have "Breast Reduction Benefits" it does not make a difference if you have all the symptoms in the world; Since you ? your employer did not pay premiums for breast reduction benefits such surgery would not be covered. If you... more

Peter A. Aldea, MD
Memphis Plastic Surgeon

Am I a good candidate for a breast reduction

Dear Marie, insurance carriers have diferent criteria for coverage. The only way to know if the surgery will be covered is to submit a letter for predetermination. This is done by your PS. He will submit photos and estimate the amount of breast tissue to be removed, as well as describe your symptoms. Most companies have a minimum tissue weight requirement based on your BSA(body surface area) and many companies require an attempt at conservative... more

Beverly Friedlander, MD
Short Hills Plastic Surgeon

Am I a Good Candidate for Breast Reduction with my Insurance

Best to see in person 3 boarded PSs in your area to examine you and have one write your insurance company a letter of predetermination. In the letter the PS will include photos of your breasts and pertain infomation.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Excess breast weight impairs lives and reduction will help

You have a petite build and your symptoms are classical for patients whose breasts are too big. There are good outcome studies that show that breast reducing relieves these symptoms and will make your daily life activities and exercise easier. Each extra pound of abdominal weight adds seven pounds of stress tho the lower back. I have never seen such data about the breasts, but it must be similar. Further, slouching and holding your shoulders forward to hide your breast size... more

Mark B. Constantian, MD
Nashua Plastic Surgeon

Breast reduction

Without an examination and determining you body surface area, i can not say. Based on your symptoms, it would appear you would be benefited by a breast reduction