Is It Possible to Get a Breast Reduction Approved by Insurance when You Are a Large C? (photo)

I am 34 year old mom of two. I lost about 100 lbs after the birth of my children. The problem is I need a reduction but am about a 32C/D. I need to know how to have insurance cover the procedure. I have to constantly duct tape by breasts up and wear an underwire, if I don't I get a rash. As of late wearing any bra besides a strapless aggregates a chronic shoulder condition. Any tips? I go for a consultation on the 5th.

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13 Doctor Answers | Asked by kjaybell in Akron, OH

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Breast reduction questions

To tell you the truth, you look like you need a lift and not much of a reduction. I don't think insurance will cover the cost, but you never know. Ask the plastic surgeon at your consult if hey think it is worth undergoing the preauthorization process. What they cover can be hit or miss, so you never know. It's worth trying.

Insurance coverage for breast reduction

Not only does each insurance company have its own requirements, each policy may have different ones. Insurance should cover only medically necessary procedures and in your case the medical reasons for surgery do not seem to be the usual back pain as much as they are the rash underneath and aggravation of your shoulder condition. After your consultation, your surgeon should send a letter to your insurance company explaining your reasons for surgery and why it is medically necessary. They may... more

Is It Possible to Get a Breast Reduction Approved by Insurance when You Are a Large C? (photo)

You need a letter of "predetermination" addressed to your health insurgence company from a boarded PS. Include photos. Odds are not in your favor to have coverage but worth the time and effort.

Some Breast Reductions are covered by insurance

All health insurance carriers differ on their criteria for covering breast reduction procedures. Your plastic surgeon will need to submit a pre-authorization letter to see if you meet their requirements. Good Luck!

Is It Possible to Get a Breast Reduction Approved by Insurance when You Are a Large C? (photo)

It does not appear that you will qualify for insurance coverage With the advantages made in breast reduction techniques, it is possible to have a breast reduction done in the surgeons office under twilight anesthesia

Breast Reduction and Insurance Coverage?

The only way to know for sure if your reduction will be covered by insurance is to get a consultaton and have the surgeon attemp to preauthorize the procedure. From your photos it does not look like you are large enough to qualify for insurance.

Breast Reduction and Insurance Coverage?

Congratulations on your significant weight loss. Online consultants cannot, with any degree of certainty, predict whether a specific insurance company will cover a specific patient's breast reduction procedure. My guess: in your case, most health insurances would not cover the procedure, based on the “weight requirements” (weight of tissue removed during the breast reduction procedure) that most health insurances follow. Your best bet is to seek in-person... more

Breast Reduction with C cups

Breast reduction from a C cup to a B cup will likely not remove enough tissue to meet the insurance requirements. Additionally, if you like the volume of your breasts, then only a breast lift should be performed. The breast lift procedure is never covered by insurance.

Breast reduction and "C" cup

It has become increasingly difficult to get breast reduction surgery aproved by insurance. A "C" cup reduction to smaller is unlikely to be approved.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Breast Reduction covered by insurance

Each insurance company has it's own set of criterias for medical coverage of breast reduction. You can inquire directly with your insurance company. Often time during your consultation, your plastic surgeon will submit a letter to obtain preauthorization. Another good source of reference is American Society of Plastic Surgeons (ASPS) website. Best Wishes,

Breast Reduction for a C Cup

Cup size is not the only criteria need to determine if your insurance company will cover a breast reduction. You should make a list of your symptoms and see what your insurance company requires for approval. Good Luck!

Insurance coverage of a small breast reduction

Most insurance companies have very strict criteria for coverage of a breast reduction. These criteria typically include appropriate documentation of medical necessity and a specific number of grams of breast tissue that must be removed. Based on your photograph, it appears that you would only require a small reduction and would most likely not meet the criteria for the number of grams of breast tissue to be removed. I usually counsel my patients that the goal of a reduction... more

Large C breast reduction will not be covered by insurance.

Hi. Your breasts are not that large and you basically need a cosmetic operation. If insurance covered cosmetic surgery, premiums would be even more astronomical than they are now. So I could not recommend an insurance company to cover your operation.