Breast Reduction: Q&A
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Approximate Minimum Amount Removal for Insurance to Cover a Reduction? (5'2, 130lbs, 34DD/DDD)?
I am 20 years old, 5'2, 130lbs and have size 34 DD/DDD breasts. Does anyone have any idea what the minimum amount that my insurance (Cigna) would require to be removed? Or, what is the minimum amount required by other insurance companies (in general) for women of this build? I am aware that this question is nearly impossible to answer accurately without an exam. But if anyone has any approximations or anything from a similar situation, I would greatly appreciate any info! Thank you!
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8 Doctor Answers |
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PINK101210
+2
Gram weight for breast reduction
The usual minimum in NY is 500 grams per breast. Occasionally, Cigna will authorize a case in the 450 gram range on a petite woman but will require documented conservative management such as physical therapy or pain medication for at least 6 months. The current guidelines, which they treat as gospel, are available on the Cigna website.
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Usually over 500gm/side
Each company is different --- call them and ask. They might not give you a straight answer, but remind them that y ou pay them for insurance and they should be responsive to you.
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What is the minimum amount of tissue to be removed in breast reduction to get insurance coverage.
Thank you for your question.
Unfortunately, getting breast reduction covered through Health Insurance has become increasingly more difficult. Each insurance carrier has specific guidelines and rules and many of them can vary. In my own area some insurance carriers require prior authorization and review of photographs before they make a commitment. Many of these companies also require a minimum of 500 to 600 g be removed.
If you are truly a triple D size...
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At size 5'2 and 130 lbs your body surface area is 1.6 meters squared. Using the Aetna table, they would require 460 gram removal. At size 34 each 100 grams corresponds to 1 cup size change. If you are a DDD that would take you down to between an A and a B. That would be an excessive amount of removal and you will be dissatisfied with the result. Insurance companies require this in order to discourage you from doing the procedure. There is an alternative...
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Breast reduction requirements for insurance
Insurance companies look at many different variables when coming up with a weight to remove from the breasts. These include; height, weight, various breast measurements, and pictures of your breasts. Most insurance companies require a weight that leaves you approximately a B cup after surgery. This can vary depending on your body habitus and BMI. Meaning, they could require 500gm per breast for a woman 6ft tall and only 250gm for someone 5ft. The best thing...
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Breast Reduction and Insurance Coverage?
Congratulations on your decision to consider breast reduction surgery; this operation is one of the most patient pleasing operations we perform.
Unfortunately, there is no way to predict with any accuracy what a specific person's specific policy requires when it comes to weight reduction surgery.
The best way to obtain insurance coverage for breast reduction surgery involves some “hoops” to jump through. The more documentation you have (for example, from your primary...
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Minimum breast reduction
There is no specific minimum breast reduction volume that a given insurance company will deem for all patients. It is based upon your height and weight. Many insurance companies make it very difficult to cover this procedure.
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Required minimum Amoun of breast tissue removed for insurance coverage
Mostof f the insurance companies cite a number of 400 cc.
You have to know that there is no science behind this regulation.
Studies have shown that even 200g reductions are beneficial and decrease shoulder and back pain.
There is a large body of literature supporting this issue.
Your surgeon should be able to fight with the insurance companies on your behalf if less than 400 grams of reduction on each side is required.
Good luck
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