Breast Reduction Q&A
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Will Insurance Approve my Breast Reduction? Am I At A Good Weight?

asked 9 months ago by MsPerry in Hinesville, GA
Latest answer by George J. Beraka, MD
Question viewed 375 times
Tags: 170-189 lbs, 5 ft 0 in to 5 ft 3 in, candidate, insurance

i heard that insurance companies base their approval on height and weight and BMI.. Im about 5'3 and i wiegh anywhere between 180-185. My bra size is 44DDD or 40F. either or, Im not quite sure what my exact size is.. If i were a patient of yours. Would you say that i would need to loose a few pounds before getting approved for surgery or am i a good enough candidate for a breast reduction?

4 answers to Will Insurance Approve my Breast Reduction? Am I At A Good Weight?

+2

Lose Weight Prior to Breast Reduction Surgery

Each insurance is different with what they "authorize" but when you visit a surgeon, they can take photos and document your back pain and write a letter asking for authorization to perform surgery. I suggest to my patients to bring in any documentation from other doctors, chiropractors, etc that can document what you are experiencing due to the large breasts. I always send photos and a letter to the insurance company to get authorization. If you were planning on... more
Tom J. Pousti, MD

San Diego Plastic Surgeon
+1

Your insurance should cover your breast reduction.

Insurance Coverage for Breast Reduction Article by George J. Beraka, MD Manhattan Plastic Surgeon 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... more
George J. Beraka, MD

Manhattan Plastic Surgeon
+1

Weight Loss and Reduction Surgery

It is difficult to predict whether your ins company will approve your surgery. If you lose a massive amount of weight such as 60 pounds or more, your breasts will get smaller and your health will improve and you become a better candidate for everything. It would be a good commitment to make. But many patients are ok with their larger size. I would encourage you to consider some options for weight loss prior to having reduction surgery but most likely would perform the... more
Steven Holzman, MD

Austin Plastic Surgeon

www.austinplasticsurgeons.com

+1

Criteria to meet for insurance to approve a breast reduction

Dear Ms Perry, It is impossible to predict what your insurance might decide since all insurance co. are different in their criteria for breast reduction approval. My advise would be to gather as much evidence/documentation of your symptoms by different doctors. These could include chiropractors, orthopedic surgeons, primary physician, spine specialist, pain specialists. The more proof you have that you are suffering by having such large breasts will help in the approval process. Your PS... more
Gary M. Horndeski, MD

Houston Plastic Surgeon

www.horndeski.com

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