Breast Reduction: Q&A
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How to Qualify for Medicaid for Breast Reduction?
Ok I just had a baby, and my medicaid ran out. They say its very hard to get it back once it runs out because its hard to prove you have a condition. Is there any way I can get Medicaid easier? How do I prove I'm having these neck and back pains? How do I qualify for the procedure?
Can I get a Breast Reduction and they still look perky and full? Do you think it's time for a Breast Reduction?
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10 Doctor Answers |
Asked by
phenom69
in Pine Bluff, Arkansas
+2
Insurance coverage for breast lift or breast reduction.
Answer by George J. Beraka, MDManhattan Plastic Surgeon80% of breast reduction questions on RealSelf are about insurance coverage. Here are some helpful points.
1) Insurance companies try very hard not to pay for breast reduction, even though they should. Even small breast reductions relieve many symptoms such as back pain and shoulder pain, and even some types of headaches.
2) Very big reductions (like from an F cup to a C cup) will usually be covered.
3) Many policies will pay for breast...
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Breast reduction by medicaid
Probably most plastic surgeons in private practice wouldn't take medicaid because the reimbursement won't even cover their costs to do the reduction. I would go to the regional university hospital where the plastic surgeons will take care of you regardless of coverage.
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How to Qualify for Medicaid for Breast Reduction?
It is extremely hard if not impossible to get Medicaid to cover a Breast reduction. Even when following their own precertification criteria, Medicaid will frequently deny coverage. The best way to have your breasts reduced is to go to a University program with a Plastic Surgery Training Program and they should accommodate you with your need for reduction of symptomatic large breasts.
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Breast Reduction and Medicaid?
Thank you for the question and picture.
Yes, I think you are an excellent candidate for breast reduction surgery.
I think the biggest challenge you will have is finding a reputable plastic surgeon who works with Medicaid.
Best wishes.
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Insurance coverage for a breast reduction
You should first check with Medicaid 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.
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Financing for breast reduction
Our breast reduction patients are some of our happiest patients. They appreciate their new look and literally have had a significant weight taken off their shoulders. As you know, some insurance policies may cover this procedure. However, it depends on the insurance policy and the insurance company. In our practice, we have seen many insurance companies do everything possible to avoid paying for medically necessary procedures such as a breast reduction. If you are not able to have your...
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Qualifying for Medicaid for Breast Reduction
I must agree with the previous expert posters. First, get a Medicaid coverage / card. Then TRY and find a boarded Plastic surgeon and hospital that accepts Medicaid. If you cannot, then by all means go to a local university hospital to the division of Plastic Surgery for this operation. Best of Luck.
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Medicaid Coverage of Breast Reduction
Perky and full is not a realistic outcome following breast reduction in your particular instance. As Dr. Rand has discussed, it is highly unlikely that most plastic surgeons in private practice would be willing to accept Medicaid. However, seeking care at a University Hospital is more reasonable option.
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Medicaid Breast Reduction
First you need to get Medicaid coverage. You should already know how to do that. I'm not sure why you are not still covered.
Next you need to see you family Dr and discuss any symptoms you might have. They will treat those symptoms or refer you to a plastic surgeon. If you are not having symptoms and just want smaller lifted breasts that is cosmetic and not covered by insurance.
Once in the hands of a plastic surgeon they will guide the process
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Medicaid coverage of Breast Reduction
From your photo, it certainly appears that you would benefit from a breast reduction. The criteria for both your participation in the program as well as the coverage of the operation varies among states. Another likely problem will be finding a plastic surgeon willing to perform the procedure if it is covered by Medicaid because of their typically very low reimbursement rates. If you live near a medical school, you might check to see if someone there could evaluate you.
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