Would my Insurance Pay for Breast Surgery?

I am 5' 4", 22 years old, and 135lbs. I have two seperate breasted sizes. One is a 36C almost a 38C and my other breasted is about a 32A or 36A. Having two different sizes does make my self confidence go down a lot. I cant wear any kind of bathing suits besides one pieces and bondous styles so I can insert two lifting pads into my top. I cant wear certain tops because of how you can definetely tell a difference. The size difference didn't start until I was 16 when I was in weight lifting class.

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12 Doctor Answers | Asked by Katharine Greenfield in Greenfield, Indiana

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Insurance coverage for breast asymmetry

Though correction of significant breast asymmetry is well worth repair, medical insurance does not recognise asymmetry as something that is medically necessary to correct. Medical insurance is trending to more and more restrictive coverage, what we call 'life or limb'. It might be worth a letter to determine coverage or a review of your plan, though we would not be hopeful.

Breast Surgery and Insurance

Hello Katherine, A Board Certified Plastic Surgeon who is contracted with insurance companies will be able to assist you with your question. We are contracted with several major providers so we have knowledge of your question. It is my experience that you will need to have a history of problems associated with your breast size well documented before you go see the surgeon. If you are a candidate for insurance coverage, they, not the surgeon and you, will dictate how much... more

Insurance coverage for breast asymmetry

Unfortunately, insurance companies consider correction of developmental mammary asymmetry to be cosmetic based on criteria related to lack of functional medical necessity. Correction of breast asymmetry is certainly a worthwhile procedure and I would recommend that you consider it and ascertain whether the cost is something that you can afford now or in the future. Best wishes.

Cosmetic Breast Surgery: The, Role of Insurance

Insurance companies are quite restrictive in the procedures they cover. If a patient meets very strict criteria, breast reduction may be covered. By law, breast reconstruction following breast cancer is covered. Unfortunately, breast asymmetry is rarely covered. This is unfortunate, but insurance companies require medical necessity to provide coverage, and they are not too concerned how a person looks or feels. What a bummer! more

Insurance Unlikely to pay... :(

Katharine: I am sorry to say that most insurance companies will not pay for this type of surgery anymore. It's not impossible, but it is difficult to get them to comply. It may be worth a shot if its your only option. best wishes, Dr. Michael in Miami

Would my Insurance Pay for Breast Surgery?

It is not common for an insurance carrier to pay for what they consider cosmetic breast surgery, but it is not unheard of either given the circumstance. Your insurer might be able to answer your question over the phone, but the insurer might ask questions that you might be unprepared to answer, such as diagnostic and procedure codes. Seeing a plastic surgeon who can help you sort through the surgical options is a good start. That surgeon can initiate an authorization process with... more

Insurance rarely covers breast augmentation

Breast asymmetry is present in everyone to some degree. The degree of asymmetry however can be very minor and barely noticeable, or very significant- as in your case. Since you have such a large size disparity between your breasts, it may be worth while to call your insurance provider and ask for a determinaiton of benefits. I would recommend tempered expectations since typically, insurance providers do nocover breast augmentation surgery, but it's worth the phone call. more

Insurance Coverage for Surgery for Breast Asymmetry?

Sorry to hear about the “self-confidence” issues that have arisen because of the breast asymmetry. It is possible, but probably unlikely, that a health insurance company will provide coverage for surgical “reconstruction”. The only way to know for sure is to call the health insurance company and see what your policy allows for. When the time is right, seek consultation with board-certified plastic surgeons. Ask to see also examples of his/her work,... more

Breast asymmetry and insurance.

Congenital breast asymmetry may be covered by your insurance company. I recommend calling your insurance company to find out your exact coverage options. A consultation with a plastic surgeon and a letter from both your primary care physician as well as your plastic surgeon may convince the insurance company to cover some or all of the costs.

David Bogue, MD

6 reviews

Boca Raton Plastic Surgeon

www.drbogue.com

Insurance Coverage for Breast Augmentation

It is very difficult to say whether or not insurance will cover surgery, because each provider is different. I would speak directly with your insurance company to find out if they would cover the surgery to correct the size issue. Also, I would suggest meeting with a board-certified plastic surgeon to discuss the procedure, as they may be able to tell you if patients have received coverage for the same surgery.