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Would Insurance Cover Breast Lift to Relieve Pinched Nerve on Shoulder?

My breasts are heavy and I wear tight bra straps 24/7 for support or else I have shooting pain down down the outer side of each breast. I have shooting pain/painful itching sensation toward the outer part of my shoulder and up the right side of my neck.

Initially, I used slip on strap pads, then was given a Rx strength hydocortisone cream Nexttreated for shingles. The pain has not responded to anything. The Dr. suspects pinched nerve on my right shoulder.

Will insurance cover Breast lift to provide some relief in the right shoulder area where I have to wear the strap so tightly?

Asked 29 months ago by WVDJC in Charleston, WV
Sort 7 expert answers by:
+2

Insurance coverage for breast lift (mastopexy) vs breast reduction surgery

Important issues as to whether insurance would cover surgery for your condition include whether you need a breast lift or breast reduction. You didn’t mention the size of your breasts but you did say they are heavy. It may be that the favored procedure would be a breast reduction. If the symptoms are well documented, a causal relationship has been demonstrated, and other conservative forms of treatment have proven unsuccessful than most insurance companies will cover a breast... more
Wayne I. Yamahata, MD
Sacramento Plastic Surgeon
+1

Breast Lifting and Insurance Coverage?

Thank you for the question. If your symptoms can be achieved it to hypermastia ( large breasts) then there is a chance that the insurance company makeup or breast reduction surgery. Most insurance companies require a certain weight to be removed as part of their “authorization”. 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,... more
Tom J. Pousti, MD
San Diego Plastic Surgeon
+1

Breast lift coverage for symptomatic issues

Insurance companies will attribute your neurological symptoms to macromastia and approve a breast reduction if you can corroborate failure of conservative methods to treat the back or nerve pain. However, without removal of sufficient tissue to qualify as a reduction, insurance would not pay for a mastopexy. You need to consider whether you would be happy reducing enough tissue for insurance coverage or if you want to maintain a larger size and pay for the procedure out of pocket. more
Robert L. Kraft, MD
New York Plastic Surgeon
+1

Breast lift coverage

If you have very large breasts and require a reduction, then perhaps insurance will cover it for you, but not for a "straight" lift.
Steven Wallach, MD
Manhattan Plastic Surgeon
+1

Insurance coverage for breast lift or breast reduction.

Insurance Coverage for Breast Reduction 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 policies will pay for breast reduction if... more
George J. Beraka, MD
Manhattan Plastic Surgeon
+1

Lack of insurance coverage for breast lift

Breast lift is a cosmetic procedure which insurance does not cover. I recommend all our patients be realistic with what insurance will cover and save or finance for their cosmetic procedure
Steven Yarinsky, MD
Saratoga Springs Plastic Surgeon
+1

Insurance coverage for breast surgery

Insurance companies will often cover the cost of a breast reduction. A pure breast lift (which involves removing excess breast skin and a small amount of breast tissue) is not covered as it is considered purely cosmetic. A breast reduction which involves removing excess skin and a significant amount of breast tissue (close to a minimum of one pound per breast) may be covered by certain insurance carriers. The particular symptoms associated with macromastia (very enlarged breasts) are... more
Sean A. Simon, MD
Miami Plastic Surgeon
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