When Insurance Denies Breast Reduction Surgery
It is unusual for your insurance company not to give reasons for denial, ask your surgeon to appeal your case, I have gotten many patients approved this way. Good Luck!
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How can I get info from insurance?
In my experience, either you and/or your plastic surgeon should be able to request a copy of the “criteria” used to approve or deny coverage for breast reduction surgery. You should also be able to read the reasons why your breast reduction procedure was denied.
Based on your description, you seem like you may be an excellent candidate for breast reduction surgeon. Continue to be persistent with your insurance company and have your plastic surgeon help you with a letter of appeal. Hopefully, your efforts will be rewarded; this operation tends to be one of the most patient pleasing operations we perform.
Insurance companies usually send you and your surgeon a letter that explains why you were denied. You cannot compare your case to your friends since it depends on your specific policy and your specific history, measurements, exam, etc. It may be an exclusion on your policy. Have you checked into that possibility?