Breast Reduction After Pregancy

You might see a plastic surgeon who can try to estimate how many grams of weight you might have removed.  This will tell you if insurance might provide coverage. 

Thank you for the question and picture. The best place to start would be with a well experienced board-certified plastic surgeon consultation. Obtaining insurance coverage for breast reduction surgery involves some “hoops” to jump through. The more documentation you have (for example, from your primary care doctor, physical therapist, chiropractor etc.) the better when it comes to obtaining insurance “authorization” for the procedure.
This documentation and... more

It has been our experience that it is difficult to get insurance companies to pay for this.  Each company is different, and have different criteria.  Most want to see a documented history of bra strapping, neck/back pain that is not alleviated by physical therapy, and other criteria.  Often the companies demand a certain amount of breast tissue be removed before they will pay.  Best to check with your individual insurance company.  Then see your Board... more

Breast reduction is indicated when large breast size causes back and neck pain and irritation of the skin from bra straps or from areas where the breast rubs against other skin. That being said, what your insurance will cover depends on your plan. I would advise that you wait at least 6 months after you have stopped nursing before considering any procedure on your breasts. You may also want to be sure that you are done having babies. If your breasts have grown this much with one pregnancy,... more

 Every insurance company is different and with breast reduction surgery, all bets are off. Without very large breasts and well documented medical reports from treating physicians, it is very difficult to get them approved.

You must consult with your Physician in regards to the neck, back and shoulder pain. It has to be documented in order for the insurance company to consider paying for it. The Insurance company will usually base there incision on a Height to Weight ratio, and how much volume your Plastic Surgeon feels that he will need to remove. Some insurance companies require that a minimum amount be removed in order to justify payment. I hope this answers your question.

Hi dana321 - All insurance companies are different concerning their policy on covering a breast reduction. Have your plastic surgeon look at your specific insurance plan to determine whether or not you meet the criteria. This can be grams of tissue removed or simply pre-authorization with photos and medical letters. However, from your photo is appears as though you may not be a candidate for a breast reduction, but again it's difficult to determine from a photo only. Good luck!... more

The best answer for this question will come from your individual insurance company. They all have different criteria. You should call them first to find out what their criteria are and then proceed with what they might require ahead of time, ex. chiropracter visit, physical therapy, family doctor evaluation, etc.

Dear Dana, EVERY single insurance company writes multiples different types of policies which are different. The FIRST thing you should do is READ the fine print in your benefits book (or ask your HR person) if YOUR policy even covers / has "Breast Reduction Benefits". Many do not. If your does not - you will have to pay out of pocket. If your policy DOES have such benefits, find out which Plastic surgeons in your area "participate" with your particular policy. If a... more

From the photos you included with your question, I doubt that you have enough breast tissue to have a large enough reduction to give you much relief of your symptoms and to be covered by your insurance. If enough breast tissue is removed to obtain coverage I think you will feel you are too small. But there is certainly no harm in checking. See a board certified plastic surgeon, get an estimate as to how much could be removed and ask your surgeon to submit it to your insurance company for... more

Your symptoms of back, neck and shoulder pain are quite typical. Most insurance companies will pay for breast reduction that needs to be done for medical reasons. However, each company's criteria are a bit different, so be sure to check with your insurance provider beforehand.