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Breast Reduction Insurance Coverage for Breast Asymmetry

I am considering breast reduction surgery. I have large asymmetrical breasts. My best estimate after a bra fitting is that I have one side that is an F and one side the is a E. I have many physical symptoms in addition to the assymetry, including difficulty with some exercise, back, shoulder, neck pain. I also cannot find a bra that fits me appropriately so most of the ones I end up wearing give me sores on the sides. Am I large enough to potentially be covered by insurance (I want a C)? What documentation would I need to submit?

Doctor Answers (3)

Breast reduction for asymmetry

+1
For insurance purposes, it is usually most relevant home much reduction is required from the larger breast.  You will likely be very happy with improved symmetry and a more reasonable breast size. Good luck.


Los Angeles Plastic Surgeon
5.0 out of 5 stars 19 reviews

Breast Reduction and Insurance Coverage?

+1

Based on your description you may be a good candidate for breast reduction surgery; It is one of the most patient pleasing operations we perform.

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 care doctor, physical therapist, chiropractor etc.) the better when it comes to obtaining insurance “authorization” for the procedure.

This documentation and letter/pictures from your plastic surgeon will help you obtain authorization. Make sure you're  working with a well-trained/experienced board-certified plastic surgeon.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 715 reviews

Insurance coverage for a breast reduction

+1

You should first check with your insurance carrrier to determine what their cirteria are. Then see a plastic surgeon. You may also need notes from a treating physician for back pain and neck pain or for rashes.
 

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

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