Breast Reduction & Insurance Coverage. What Are the Necessary Steps? (photo)

I'm 22 years old and I've always had bigger breast. I was a D/DD in middle school and was currently sized in at a 38H, but would like to go to a 38D cup. I have gained and lost and gained and lost and had my first child March of last year. It all has taken a toll on my breasts. Besides that, I have always had problems concerning them, incuding really bad self-esteem issues, back pain, deep shoulder grooves and pains...my main insurance provider is NJ Horizon Health. Necessary steps? Thank you.

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H cup insurance

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2 Doctor Answers | Asked by ShekiraFarrell

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Breast Reduction through Insurance

Thank you for your question and photos. Congratulations on your decision to proceed with 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... more

Steps for insurance coverage of breast reduction

Each insurance company has its own guidelines. Rather than asking plastic surgeons who practice in other parts of the country, I recommend that you access Horizon BCBS's website and read the criteria for yourself. They are subject to change at anytime. If I recall correctly, Horizon's criteria were particularly harsh in terms of the length of time patients had to document conservative medical management including physical therapy or chiropractic. Best of luck!