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Will my insurance cover Breast Reduction in Atlanta?

Prior to moving to Atlanta almost 3 years ago, I had a recommendation from my doctor to seek a breast reduction. Previously, I was on Medicaid in SC but I was instructed to lose weight before approval to receive my reduction. Now, I am a resident of GA and I am still having the same back problems, along with extra breast tissue under my right arm. I've been on my job for over a year and now I'm inquiring if my insurance would approve this reduction. I have Aetna PPO and my breast are 42 DD. Please help?

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10 answers to “Will my insurance cover Breast...”

A: Will my insurance cover Breast Reduction in Atlanta?

Peter A. Aldea, MD

BAD NEWS - Each insurance company has multiple policies (IE "products) which were paid for by the employers. Some employers buy the the all-options insurance, others save money by leaving out several coverages. Breast reduction MAY be one of them. There is NO WAY of knowing if your policy pays... more

A: Breast Reduction

Farbod Esmailian, MD

It really depends on the specific insurance and who is doing the review.  It also depends on your height and weight along with the photos and measurements that are submitted. More and more patients are being denied for breast reduction under insurance so it is hard to say that you will be approved. ... more

A: Insurance coverage for breast reduction

Jeffrey Zwiren, MD

There are many factors that go in to the process of approval for a breast reduction.  It seems that you have the usual set of symptoms that are associated with large breasts.  During an evaluation specific measurements can be taken as well as a determination of the amount of breast tissue to be... more

A: Insurance coverage for breast reduction depends

Andrew Y. Kleinman, MD

Breast reductions may be covered by your insurance or maybe not. It depends on a few factors. One: Is the physician in network or out of network? Not all physicians (especially plastic surgeons) participate in insurance plans. If you want to stay in network, (have no payments or limited out of pocket) then you... more

A: Worth trying, but no promises will made from the insurance company

Hisham Seify, MD, PhD

Every inssurance company has special requirements for approving breast reduction. You will require a consultation with a board-certified plastic surgeon. His office will contact the inssurance company on your behalf to get pre-approval for the surgery. As all inssurance companies are very protective of their... more

A: Breast reduction coverage by insurance

Jeffrey E. Schreiber, MD

Every insurance company is different.  Some approve reductions by weight removed and some by height and weight.  Check with some local plastic surgeons to see if they take your insurance.  If they do, see what they can do to get you approved.  Also, you may want to consider a University... more

A: Insurance coverage for breast reduction

Otto Joseph Placik, MD

Your best option is to select a plastic surgeon and present for a history and physical examination. The physician can then submit  a predetermination of benefits letter with photographs to your insurance company to determine if they will cover the procedure.

A: Insurance coverage for breast reduction

Sam Jejurikar, MD

If you have documented symptoms of back pain, neck pain, shoulder pain, severe grooving from your bra straps, or rashes, your insurance carrier may cover a reduction mammaplasty. You should check with your insurance carrier to ensure that you don't have any exclusion policies for breast reduction and to see if... more

A: Check with your insurance company

Dean Fardo, MD

Each case is different. Best to check with your insurance carrier to see if they even cover breast reductions as many insurers do not. If they do, then find a plastic surgeon who participates with their plan. (there may not be too many choices). After a consultation, the doctor should be able to tell you if... more

A: Insurance Coverage of Breast Reduction

John Whitt, MD

Many breast reductions are covered by insurance.  Most companies look at your symptoms and your body surface area when deciding.  You should obtain a referral from your doctor or search the ASAPS or ASPS websites.

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