Breast reduction size for insurance to cover surgery?

In order for breast reductions to be covered by insurance, several criteria need to be met. Patients must have a documented history of symptoms such as neck/back pain and show some type of treatment for this-pain medication, physical therapy, accupunctur, etc. Also, the insurance companies will require... more

Dear Cole Altho you may be a 40DDD you don't tell us your height and weight. Many of the insurance companies will look at this as a factor in determining the body surface area and then deciding or setting a scale on what needs to be removed for the procedure to be covered. You may be 5'1" and 100 pounds... more

One of the great mysteries in medicine is "will my insurance company pay for my breast reduction?"  Of course there's no reason that a company that is being paid premiums should hide this information.  But they do.  So here's what you will need to do.  First, your insurance... more

Breast reduction has one of the most satisfied patient populations of any plastic surgery procedure. Whether or not insurance will cover the procedure really depends on your specific plan. Each insurance company will have many different plans and sometimes an employer may set their own rules for coverage. Over... more

It has become more apparent with the recent health care debate that insurance is a regional issue and coverage will differ widely state to state, and locally plan to plan. People are also discovering that a company such as Blue Cross will issue dozens of differing plans with differing levels of coverage.... more

First - you need to look at your insurance book to see if your PARTICULAR policy even pays for breast reduction surgery. Each  insurer sells different VERSIONS of its policies and just because you have let's say CIGNA does NOT mean that YOUR policy is the same as your neighbor's. They are not. IF your... more

It is no longer determined by the 500 gram rule.  It all depends on your height and weight which is plugged into a equation which gives BSA (body surface area).  This gives a number which determines how much breast tissue is required to be removed for insurance to cover it.  It depends now on... more

Most insurance companies would cover the reduction of extremely larger breasts in symptomatic patients.  If the patient has a history of bra strap grooving, neck and back pain that is documented it has a good chance of getting covered provided that you fall within macromastia criteria consistent with... more

Insurance for breast reduction surgery is highly variable. Often there are a number of conditions that must exist before your insurance would consider it medically necessary. This includes presence of infection, rashes, ulcers, back pain, shoulder grooving. However, some are qualified by requiring you to have... more

Every insurance company has their own criteria. You should check with your company. Your doctor should be able to show you what the reduction amount looks like by showing you that size of breast implant. It gives you an idea of what will be removed and what you will have left in place.