Breast Reduction: Q&A
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I am 5 ft 9 in, I weigh 140 lbs and my breast size is a 36 e. Would Horizon BCBS Cover BR?
I am 5 ft 9 in, I weigh 140 lbs and my breast size is a 36 e. I was trying to figure out the chances of horizon blue cross blue shield of nj covering a breast reduction surgery for me?
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6 Doctor Answers |
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olivia in nj
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Insurance coverage for breast reduction
It is very possible that your insurance will cover your breast reduction. Each insurance company requests different information, you may want to call them, An exam of course will be necessary.
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You will probably get insurance coverage for your breast reduction.
Hi.
I hope you find this article useful. 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) will usually be covered.
3) Many...
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Insurance prior approval for breast reduction surgery
From your description you are a good candidate for breast reduction surgery. There is no way to know in advance if you would be approved for the surgery until you are evaluated by a plastic surgeon. At that time medical necessity can be established and you can begin the process of getting prior approval from your insurance company.
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Breast reduction and insurance coverage
Dear Olivia,
Based on your description you are likely a candidate for breast reduction. Your symptoms will need to be assessed and you need an examination by a board certified plastic surgeon. Once your plastic surgeon establishes medical necessity for you, he/she would act as a patient advocate to get authorization from your insurance company before the procedure. Do come in for a consultation and evaluation to explore your options.
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Horizon BCBS coverage for breast reduction
Horizon has very tricky criteria for breast reduction and, for personal experience, I must say that it stands out as a carrier which may approve a surgery in advance and then try not to pay afterwards so extreme caution is required. It requires detailed proof of conservative medical management. The best thing to do is to see a board certified plastic surgeon in NJ who has had a lot of experience dealing with this insurance company and can explain the criteria to you in detail. I would...
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Breast Reduction ad Insurance Coverage?
Thank you for the question.
The best way to find out whether your insurance policy will potentially cover your breast reduction procedure is to call the insurance company directly. This way you will find out if the procedure is “covered” in your policy.
Obtaining insurance coverage for breast reduction surgery involves some “hoops” to jump through. The more documentation you have (for example, from your primary care doctor, physical therapist, chiropractor etc...
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