BSBC of Texas Cover my Breast Reduction?

I have BSBC of Texas the PPO plan and I was wondering if the insurance would help pay for a breast reduction. I am 21 years old I am about 5'0 weight about 140 lbs. I work out and I believe I am in good shape but my breasts are uneven they are a 38DD, I have frequent headaches, my neck is curving, I have shoulder indentions, I have bad posture, and when I got a physical they told me my back was curving wrong!! my mother had a breast reduction and also was a DD. She had 4000 grams taken out.

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age 18-24 DD cup uneven 5 ft 0 in to 5 ft 3 in 130-149 lbs Blue Cross/Blue Shield candidate

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8 Doctor Answers | Asked by Sanissya

Doctor Answers (8)
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Insurance coverage for breast reduction

Thank you for your question. Based on the symptoms and physical findings you have described, I think you would be a good candidate for a breast reduction. Many insurance companies will cover a breast reduction but often make it difficult and try to deny coverage by saying it is a cosmetic operation. You will need to check your explanation of benefits from your insurance company to see if this is a covered procedure. If so, consult with a board certified plastic... more

Insurance coverage for a breast reduction

Based on your description of your size and your physical problems, you sound like an excellent candidate for a breast reduction. Review your policy coverage or contact your benefits administrator to find out if breast reductions are covered by your insurance plan. If they are, find a board-certified plastic surgeon and have a consultation. Your case can then be submitted for approval by your insurance plan. Good luck!

Breast insurance for breast reduction

Based on your description, you have good chance of insurance covering breast reduction. You should consult with a plastic surgeon who can initiate the preauthorization process for you and determine if you meet the insurance company's criteria.

Candidate for a breast reduction and insurance coverage

Most PPOs will cover a medically necessary breast reduction. The first step is to be evaluated by a plastic surgeon in your area. From your description you would seem to be a good candidate for the procedure

It Depends

Dear Sanissya, I would love to give you a simple answer of yes but I can't. Some insurance policies do NOT cover breast reduction, plain and simple, and it is spelled out in the contract. Others require pre-authorization and it is dependent upon a formula called the Schnur Scale. This calculates body surface area based on your height and weight and then gives you an amount in grams that needs to be resected (removed) for insurance to consider covering it. Most plastic surgeons will be happy... more

PPO Coverage for Breast Reduction

PPOs usually cover breast reductions, but many have specific amounts of breast tissue that must be removed. Your plastic surgeon will be able to advise whether or not the amount removed meets your expectations.

Breast Reduction and Insurance

Each insurance company has different policies, within one insurance company one policy may cover and another may not. You can contact your insurance company directly and ask if yours is a covered procedure and/or have your plastic surgeons office check for you. If they do cover it, they will have certain requirements and again your surgeons office should be able to help you get pre- authorization. It is getting more difficult to get approval these days, if you get denied, ask for... more

Insurance coverage for breast reduction

It is impossible to say for sure on line. However, here is how you go about getting a real answer. First since there are so many policies go to your HR person, or whomever knows YOUR coverage. Some plans exclude it completely. Find out what the requirements are. Armed with this information, you go to a plastic surgeon and see if you would qualify. Based on your description, you would be greatly helped with a reduction. sek more