I Am 5'5" Weighing 165 and Have a Size 36I Breasts. Would BCBS Cover a Breast Reduction for Me?

I have been to two plastic surgeons in the past who agree that I need a breast reduction but my insurance at the time would not cover it. I have deep groves in my shoulders, a pinched nerve in my neck and severe back pain from carring such large breasts. I have a medium frame. I have dieted over the years but do not seem to lose my breast size. Am I a canidate for breast reduction and would my insurance cover the operation?

Tags:

l cup 5 ft 4 in to 5 ft 7 in 150-169 lbs back pain Blue Cross/Blue Shield candidate insurance

Comment on this

4 Doctor Answers | Asked by pcakes

Doctor Answers (4)
Community Comments (0)

Criteria for Reduction

Insurance companies cover breast reductions based on 2 criteria. First, you must have symptoms relating to the large breasts such as neck, back or shoulder pain or rashes. You have met that criteria since you have back pain. Second, the amount removed has to meet their requirements. From your height and weight, they calculate your body surface area and use a table that predicts the amount to be removed. At 5'5 and 165 lbs, your body surface area is 1.84 meters... more

Insurance and breast reduction

Unfortunately, insurance companies are getting notoriously more difficult to deal with and getting approval for breast reduction surgery. You may have to pay out of pocket to have it done. Good luck.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Hello

The only way to determine whether your insurance would cover that is to talk to your primary doctor and they would have to do an authorization for the procedure.

Breast Reduction and Insurance Coverage?

Thank you for the question. Based on your description you may be a good candidate for breast reduction surgery. 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 doctor, physical therapist, chiropractor etc.) the better when it comes to obtaining insurance “authorization” for the procedure. This documentation and letter/pictures from your plastic... more