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Financing Breast Reduction Through Insurance?
If one of my breast is extremely larger than the other. Will insurance cover the procedure? One side is probably a very small A and the other is a very full B, almost C. What's your experience with this?
Asked 35 months ago by
melinda_cavazos in Houston, tx
+3
Unilateral insurance breast reduction depends on insurance coverage and previous treatments tried
Each insurance plan has their own policy about coverage for asymmetry. Your best bet is to start with getting letters of support from your primary and or gyn physician stating the issues you deal with because of your asymmetry (i.e. back/ neck/ breast pain, rashes, grooving of the shoulder(s), inability to fit a bra properly, discomfort with certain activites etc).
I would recommend that you write a letter also telling the insurance company the issues you deal with because of your...
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+2
Every insurance company is different
Every insurance company is different. The only similarity is that they all try to deny and delay so they do not have to pay for anything. However, if you have a significant asymmetry, the it is worth pursuing insurance coverage for the procedure. Good Luck.
+2
Functional, reconstructive, and cosmetic plastic surgery
Despite what you may consider severe asymmetry, many insurances no longer cover these procedures.
In the past, insurance companies would pay for reconstructive surgery, and this included congenital deformities or severe asymmetry such as yours.
However, recently they have changed their definition to functional surgery. This is interpreted as meaning that only surgery that improves your function will be covered. In your case, this is not functional surgery and would likely NOT be a covered...
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+2
No insurance will cover this
Breast asymmetry is not a covered benefit under any insurance. They make a very clear distinction between "functional" vs "cosmetic" issues and this would clearly be cosmetic unfortunately. Also, in terms of insurable breast reductions, you don't sound large enough to apply for coverage because most all insurances require 500 grams (1 pound) of tissue to be removed from each side. At your cup sizes, there isn't this much extra tissue.
+1
Breast Asymmetry and Insurance Covered?
Thank you for the question.
Unfortunately, it is very unlikely that the insurance companies will provide coverage for your situation ( breast asymmetry). I will suggest that you consult with well experienced board-certified plastic surgeons for more precise advice.
Best wishes.
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Breast Surgery and Insurance
Unfortunately the type of surgery you would need would not be covered by insurance. You have a couple of options, you could have one side reduced but then you would have very small breasts, or you could get an implant on one side to even out your breasts. But either way, insurance will not cover the surgery as it is not considered medically necessary. In order for a reduction to be covered you would need a minimum of 500 grams of breast tissue per side to be removed, and for most women...
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Insurace and breast reduction
If you have very large breasts which are causing back pain, your insurance provider may cover your procedure. Usually they are looking for about 500 gms of breast tissue to be removed per side. This varies amongst the different providers so I would check with your plastic surgeon and your insurance carrier. Breast asymmetry typically is not covered unless it is quite severe. Your surgeon needs to document your symptoms and submit photos to the insurance company...
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Insurance will not cover cosmetic asymmetries of the breasts.
It's getting to the point where insurance covers much less of what plastic surgeons do. However, cosmetic asymmetries of the breast have never been paid for by insurance companies (and probably shouldn't be). The procedures are fairly common, outpatient, with little downtime.
The cost of various breast operations is listed on my website.
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Breast reduction is covered by insurance when medically necessary
Unfortunately, surgery to correct breast asymmetry is typically not covered. Even though your breasts are different sizes, and I'm sure that bothers you, there is no functional problem. Insurance would not cover your surgery. The only caveat to this would be if you happen to have Poland's Syndrome. In that case, it would be covered. Seek a consultation with a board-certified plastic surgeon, who can help you sort this out.
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Breast Reduction and Insurance
Most traditional insurance company will cover the cost of breast reduction after meeting certain criteria. However, some will exclude this benefit. It is important to review your health insurance policy.
Differences in your breast size may not qualify for breast reduction. This may be considered cosmetic surgery by your insurance company. Unless you have a symptoms related to your breast size such as neck pain, back pain, skin issues etc, your insurance company will not cover the...
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Most Insurance Companies will NOT pay to correct a Breast Asymmetry
To have any reasonable hope that your insurance company will pay for anything, that medical condition MUST be stipulated in writing as a "covered benefit" in your contract with the insurer. If it is not on the contract, you / your employer did not/are not paying for that coverage and the insurer is not legally obligated to pay for it REGARDLESS of how important it may be to you.
In addition, all surgeons can tell you that even if you do have a condition which IS a...
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Insurance coverage of Breast Reduction
Insurance criteria for medically necessity is changing almost daily and becoming extremely rigid, so you would be well advised to read the fine print of your policy. My experience mirrors the other consultants. Insurance will not usually cover breast reduction until a solid case has been submitted, documenting 1) musculoskeletal (neck, shoulder, back pain) treated by primary care, orthopedic, chiropractors, etc; 2) skin rashes treated by dermatologists; 3) failure of...
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Breast Reduction and Insurance
The process to receive insurance reimbursement for the breast reduction procedure can be quite frustrating. Moreover, different insurance companies generally have different requirements. There are a series of questions that must be answered prior to beginning the insurance process.
1. Have you experienced persistent symptoms in at least two of the anatomical body areas below, affecting daily activities for at least one year:
*Pain in upper back
*Pain in neck
*Pain in...
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Insurance coverage for breast reduction surgery
Insurance coverage for your surgery depends entirely on your policy. Some insurance policies specifically exclude breast reduction whereas others will allow it after a medical clearance or an additional valuation by a orthopedist, physical therapist, or even a chiropractor. Your best course of action is to visit with a board-certified plastic surgeon and receiving evaluation. Your plastic surgeon will then examine you, review your surgical options, obtain photographs and send...
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Cosmetic breast procedures are not covered by insurance
Unless you have a functional problem related to your breast size (neck pain, back pain, skin issues etc) its unlikely an insurance company would fund a procedure that is designed to restore symmetry to your breasts. This is a cosmetic procedure designed to enhance your appearance. Seek out a board certified plastic surgeon for a consultation and price quote for this cosmetic procedure.
+1
Doesn't sound like a classic breast reduction
You sound like you have a problem with breast symmetry not large breasts. You will likely be looking for implants and breast lift surgery which are less likely to be covered by health insurance. Look into it anyway as you might get lucky.
Best Regards.
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Insurance and breast reduction
If you just have asymmetry more than likely the insurance company will not cover your procedure. I you have a congenital deformity like Poland's syndrome they might.
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Insurance coverage for breast reduction
In my experience, they will not cover it in this situation. If the large breast is causing you a problem such as back pain, etc. you might be able to make the case for them to cover reduction on that side. You will probably need letters from an orthopedic or neurologist documenting that the large breast is creating a medical problem for you. Call around to plastic surgeons in your area and see if any have an insurance consultant. This person could help you with this. Hope this helps.
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Insurance commonly covers reduction of very large, heavy breasts
Insurance companies differ, but they commonly cover reduction of very large, heavy breasts that cause back, neck and shoulder pain. Such surgery is quite common and a great relief to many patients.
Your situation is different. Your condition sounds like asymmetry. A variety of treatment options are available to you including reduction, augmentation, or lifts done differently on each breast. When we treat such a condition in our practice, insurance payment is usually not involved.
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No insurance won't cover it
I do many reviews for insurance companies for both breast reduction and breast asymmetry. The reality is that your insurance company doesn't care that you have a debilitating breast abnormality. Your insurance company is only concerned about making money so the less they pay to physicians for surgery the more they keep and pay to their stockholders.
So my vast experience is that they will not pay for your surgery. Save up the money, get the opinion of several surgeons and proceed with a...
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+1
Depends on the insurance company
Coverage for breast asymmetry without any symptoms of back and neck pain or other functional disability will likely not be a covered benefit for most insurance companies. However, all insurance companies have different criteria and it really depends on your specific plan. Almost all, however, will consider this a cosmetic procedure and will not be a covered benefit. You can get a consult with a board certified plastic surgeon to go over your question in more detail after a full evaluation.
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Medical insurance for diseases, not asymmetries
Does not sound like a disease! Medical insurance is designed to treat diseases, not assymetries. In my experience, it is not right to try and bill an assymetry in the same manner as say large breasts. Large breasts can cause back pain, breast pain, notching of the shoulders, rashes under the breasts. All of these things can make a woman suffer miserably. We should not attempt to use money designed for this problem for something that is only emotionally troubling--unless your insurance...
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