Breast Reduction: Q&A
Ask a QuestionAm I Big Enough to Qualify for a Reduction (Via Insurance)? (photo)
I'm 5'5, 142 lb, 39 years old. I wear a 36DDD (fitted at a local bra shop). I am not having any more children. I am suffering from awful backaches - I am seeing a chiro (had to break down to do it because I'm in agony!). I looked at the UHC schnor scale and I think I would need at least 404g removed per breast. I would love to be a C (golf, running, etc.) I'm also pretty lopsided - one side is 1 cup size larger? Does it sound like I have enough to remove?
Tags:
12 Doctor Answers |
Asked by
Laura43546
+2
Qualifying for breast reduction
You may indeed qualify, but we have all misjudged size based on photos and an exam with a board certified plastic surgeon who frequently performs breast reduction surgery is the best way to get started. Then, if you seem in range to get insurance coverage, a letter is written to your insurance with all the proper documentation to try to get you the best chance of obtaining pre-authorization for the procedure. I hope you look into it further. It is one of the surgeries we...
more
+2
Insurance coverage for Breast Reduction
If you are having back pain from large breasts, your insurance should cover the procedure; however, it will depend on your insurance. After fighting the coverage for Breast Reduction for years, some insurance companies have started to exclude Breast Reduction as a covered procedure in all circumstances. Others have set minimum weight limits for the excision, and will only allow surgery after certain qualifications have been met like weight loss, trial of physical therapy and documentation...
more
+1
You may qualify but not get the desired outcome
At 36 DDD each cup size is 200 grams. If you are going down 2 cup sizes (400 grams) you would be a D. However, the surgeon could take off more. 600 grams would make you a C if that is what you desired. Insurance companies base approval on 2 factors. First, you must have symptoms related to the large breasts such as neck, back and shoulder pain or rashes. Second, you must meet their weight criteria (which you say is 404 grams), which you should easily meet...
more
You might also like...
Real Stories
Waiting for a Response from Dr. Yily in Respects to a Quote for my Surgery - Dominican Republic, DO
So i've finally decided to do my surgery with Dr. yily de los santos I'm 5'5, 160 pounds (...
+1
Qualifying for Breast Reduction Surgery
Based on your dimensions, photo, and symptoms, you appear to be a candidate for breast reduction surgery. If your primary care physician provides documentation and treatment of your symptoms arising from your breast hypertrophy, you should be able to have insurance pay for breast reduction surgery. If you are approved by insurance, you could then be evaluated by a plastic surgeon for surgical treatment. With a proper evaluation, your plastic surgeon will be able to estimate if a 404...
more
+1
Enough breast tissue for a breast reduction.
By your photos and description you may be a good candidate for breast reduction. It is a bit difficult to say for sure without a physical examination as some breast tissue is more dense (thus heavier) than others. Insurance coverage is discussed well by other responses to your question on this site. I would encourage you to meet with a qualified plastic surgery to discuss your concerns and have a personal physical examination.
+1
Insurance Coverage for Breast Reduction - "It Depends"
Insurance coverage is NOT a simple entity. Instead, just like all restaurants (in principle) serve food but each has different items on their menues, each commercial insurance company sells MANY DIFFERENT policies (dishes). Some obviously cost more than others. It is therefore a mistake to ASSUME that just because several people went to restaurant X - they all had the exact food.
To make things MORE difficult, just like certain dishes contain certain ingredients that others do not -...
more
+1
Breast Reduction through Insurance
Insurance will often cover breast reduction when there are symptoms associated with large breasts. These include back pain, neck pain, shoulder grooving from the bra strap, shoulder pain, paresthesias, and recurrent breast rashes. Insurances expect a certain amount of reduction depending on your height and weight for them to approve. A full consultation with a board certified plastic surgeon and insurance predetermination are required.
+1
Am I Big Enough to Qualify for a Reduction (Via Insurance)?
It depends on so many variables. Like what health insurance plan? Write a "pre determination letter to your health insurance company. Obtain a mammogram ASAP. Than see if you are considered a qualified candidate. Good luck.
+1
Breast Reduction and Insurance Coverage?
Thank you for the question and picture.
As you know, it is not possible to give you precise advice without direct examination. Your best bet would be to meet with well experienced board-certified plastic surgeons; asked to see lots of examples of their work.
My initial impression evaluating your picture is that you may be left with breasts that are too small ( proportionality wise) if enough tissue is removed to satisfy health insurance company requirements...
more
+1
Breast reduction
First, it is very difficult to assess you from just photos. I will say that the right breast looks very small and may not be able to be reduced significantly to achieve that weight removal. Also, each insurance company is different and have different criteria for removal.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
Comments (0)