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Breast Lift After Weight Loss Insurance Coverage

I'm almost 18 years old, I lost a lost of weight weight, 80lbs in about 2 months. My weight gain was due to side effects of meds I was on for almost 2 years (Depakote and Zyprexa). At my biggest I was 210lbs and now I weigh 125lbs. I'm self conscious and embarrassed of my breasts; they look disgusting and saggy. Is there any way my insurance (BC/BS) would cover a breast lift?

Doctor Answers (13)

Breast lift after weight loss - insurance coverage?

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Hello! Thank you for your question! Surgical procedures for aesthetic purposes, to improve appearance, are not covered by insurance. Typically, these as well as complications resulting from such procedures are the responsibility of the patient. Procedures that are meant to correct functional issues and those which cause health-related issues should be covered by your insurance as a medical necessity, with proper examination and documentation. Some insurance plans have exclusion criteria for certain procedures. Also, it is an obligation of the surgeon not to attempt to authorize purely cosmetic procedures through insurance.  This is not a covered benefit for this reason.

Discuss your issues and complaints with a board-certified plastic surgeon to discuss these as well as to examine and assist you in deciding which procedure(s) will be the best for you. A discussion of the advantages and disadvantages will take place along with the risks and benefits. Insurance companies will vary on coverage and is always reasonable to discuss your issues with your surgeon and primary care. It would behoove you to get as much information as possible and even call your insurance yourself. Certainly, pay in advance prior to your surgical procedure and options such as financing are available if you qualify. Hope that this helps! Best wishes!


Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Insurance and breast lift

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Cost is geography dependent. In Florida it runs $6000-8000. More important than price is safety and experience. Also, as an aside, breast lift, has never been a covered procedure with any insurance carrier unless it is to match a breast reconstruction for breast cancer.

Raj S. Ambay, MD
Tampa Plastic Surgeon
4.0 out of 5 stars 15 reviews

Breast Lifting and Insurance Coverage?

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Congratulations on your significant weight loss.

Patients who have had successful weight loss to the degree that you have experienced,  often benefit from breast augmentation as well as breast lifting surgery.  Neither one of these procedures are typically covered by health insurance plans.

I would suggest in person consultation with well experienced plastic surgeons who can demonstrate significant experience with patients who have had significant weight loss.

Best wishes. 

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 752 reviews

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Breast lift insurance coverage after weight loss

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When bariatric surgery was a novelty, some carriers covered a variety of what would be considered cosmetic procedures after significant weight loss. However, now that lap banding and other procedures are much more common, they have cracked down. I know of no NY company that would pay for a lift even given that your weight gain was induced by medication prescribed for treatment of a medical condition. Best of luck!

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 12 reviews

Breast Lift after weight loss

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Unfortunately, breast lift is usually not covered by most insurance companies for any indication. This is not considered "medically necessary". Breast reduction may be covered but a certain amount of tissue has to be removed and specific symptoms such as back and neck pain must be present. Most patients that have lost weight only need a lift and sometimes an inplant to correct sagging.

John M. Pierce, MD
Phoenix Plastic Surgeon

No insurance coverage for breast lift

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I am sorry to inform you that a breast lift is not a covered service under any health insurance plan. This is an elective cosmetic procedure. By definition there are no functional limitations related to sagging breasts even after massive weight loss. If your breasts are excessively large a D cup or larger then a breast reduction may be covered if there are related symptoms and you fulfill the prerequisites of you health insurance plan.

Todd B. Koch, MD
Buffalo Plastic Surgeon
4.5 out of 5 stars 9 reviews

Breast lift after weight loss insurance coverage

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As you can see the expert panel of posters, all (100%) agree that breast lifts are a non insurance covered benefit. But if you still would like to try I would have an evaluation with a board certified plastic surgeon. Then ask him to write to the insurance company a pre-determination letter including photos. Maybe, just maybe, you will get an approval. But I doubt it. Regards and best of luck.

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 62 reviews

Insurance Coverage for Breast Lift (Mastopexy) after Large Weight Loss

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No insurance company that I am familiar with will EVER cover / Pay for a Cosmetic procedure REGARDLESS of the reason. Breast Lift is a cosmetic operation and you will have a very hard time finding any insurance that would pay for it, be it BCBS or others.

Sorry.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 62 reviews

BCBS does not cover breast lift

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Great job and keep up the good work. You need to have breast lift and insurance companies do not cover breast lift. This is more specific for the BC/BS, they do not cover breast lft or breast reduction.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
5.0 out of 5 stars 58 reviews

Insurance coverage for Breast Lift

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Breast lift is considered a cosmetic procedure, while a breast reduction is considered reconstruction, or medically necessary. Cosmetic procedures are not covered by insurance. Best to check with a plastic surgeon, perhaps he can find a way to get it covered.

sek

Scott E. Kasden, MD
Dallas Plastic Surgeon
4.5 out of 5 stars 47 reviews

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.