Breast Reduction Q&A
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Will DC Blue Cross Blue Choice Plan Cover my Breast Reduction?

asked 1 year ago by nikki 74 in dc
Latest answer by Tom J. Pousti, MD
Question viewed 432 times
Tags: Blue Cross/Blue Shield, DD cup, insurance

I am 4'11" 154 breast size is 42dd I've been suffering with neck and shoulder strain for yrs, I have blue cross blue shield blue choice plan help!

8 answers to Will DC Blue Cross Blue Choice Plan Cover my Breast Reduction?

+1

Breast Reduction Insurance Coverage?

Thank you for the question and congratulations on your decision to proceed with breast reduction surgery. It is one of the most patient pleasing operations we perform. Based on your description you may be a good candidate for breast reduction surgery; for physical and emotional reasons. 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... more
Tom J. Pousti, MD

San Diego Plastic Surgeon
+1

Breast reduction

Blue cross will frequently cover breast reduction. However each pkan has specific requirements to obtain authorization
David L. Abramson, MD

New York Plastic Surgeon
+1

Blue cross Blue shield coverage fo breast reduction

Your best bet is to find a participating surgeon and go in for a consultation and have a predetermination of benefits letter composed to ascertain your level of coverage.
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

Breast reduction insurance coverage.

Insurance Coverage for Breast Reduction Answer by George J. Beraka, MD Manhattan Plastic Surgeon 80% 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)... more
George J. Beraka, MD

Manhattan Plastic Surgeon
+1

Insurance coverage of breast reduction

The best way to get accurate information about whether or not your insurance company covers breast reduction surgery is to contact them directly and find out what their criteria are for determining "medical necessity" for the procedure. Some criteria may include physical attributes such as height, weight and bra size, symptoms such as neck and back pain, and documentation of evaluation and attempt to treat symptoms by specialists such as orthopedic surgeons and neurologists.... more
Olivia Hutchinson, MD

New York Plastic Surgeon
+1

Insurance coverage for breast reduction

To figure out if your insurance will cover your breast reduction, you should contact the insurance company and ask them what their criteria are for approving breast reduction surgery.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

BCBS coverage for breast reduction is possible

I'll bet you're a good candidate for insurance coverage for breast reduction, given your data.  You will need documentation from a non-operating physician (your PCP, GYN, etc) regarding symptoms related to your breast size.  They will need to document your back pain, neck pain, shoulder pain, etc, document how long you've had this pain, what you've done to alleviate the pain, the fact that the pain returns despite these measures, and that they think a breast... more
Carmen Kavali, MD

Atlanta Plastic Surgeon
+1

DC Blue Cross Blue Choice Plan Cover my Breast Reduction

Seek appointment with a provider plastic surgeon listed in your provider booklet. The provider plastic surgeon will examine you and write a predetermination letter to BC/BS. Then waiting for the response can be days to months, why? I really have no answer. If approved than your breast reduction surgery, hospital stay and anesthesia will be covered. Except for deductibles, co-pays, out of pocket plan expenses to the patient. In most incidences the out of pocket costs to the patient range... more
Darryl J. Blinski, MD

Miami Plastic Surgeon

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