Can Insurance Cover a Breast Reduction Surgery if Your Breast Are Effecting You Emotionally?

I'm 5'2 and 120 lbs. I am a 36 DD, I'm experiencing a little neck pain and numbness in the hand. I'm emotionally drained, I hate having big breast! Can insurance pay for my procedure? If so what steps should I take?

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7 Doctor Answers | Asked by Cathy91 in San Bruno, CA

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Insurance and breast reduction

Many insurance companies do cover breast reductions for medical necessity, although different policies often have slightly different requirements for coverage. Examples are whether or not you have failed "conservative" measures (non-surgical) to relieve your symptoms, or how much tissue is estimated to be removed by your plastic surgeon compared to your body mass index or body surface area. The first step is to research your specific insurance policy to see if breast... more

Insurance Coverage and Breast Reduction

Emotional reasons aren't usually what insurance companies take into consideration for approval of breast reduction surgery, however based on your height, weight and breast size you would most likely qualify. Each insurance company has their own requirements for qualification. It is best to see a Board Certified Plastic Surgeon that specializes in breast reduction surgery. Your surgeon and his/her staff will be able to help you go through the process for pre-authorization. If... more

Question as to the possibility of insurance covering breast reduction surgery

If an insurance will cover a breast reduction, it is usually based on their somewhat strict criteria based on physical issues rather than emotional ones. These are related to a relationship between your height, weight and the expected amount of breast tissue to be removed as well as symptoms that you may be experiencing such as neck, back and shoulder pains, shoulder grooves, etc. You need to first see if your insurance company does even cover breast reduction surgery. If so, go see one... more

Breast reduction insurance coverage

Based on your description you may be a good candidate for breast reduction surgery; for physical and emotional reasons. 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... more

Coverage Of Breast Reduction For Emotional Reasons

Your insurance company is unlikely to cover your reduction for emotional reasons. You do sound as if you would be a good candidate for a reduction based on your size and dimensions. Go ahead and obtain a consultation with a board-certified plastic surgeon who can communicate with your insurance carrier. You may have to jump through some hoops (trial of physical therapy and pain meds, for example) but hopefully can have your procedure ultimately approved. more

Can Insurance Cover a Breast Reduction Surgery if Your Breast Are Effecting You Emotionally?

Yes health insurance has a predetermination policy where you see a boarded PS who will examine you and take your breasts photos to send a letter to your company. If you meet the qualifications outlined in your plans policy than you will receive a return letter of approval. Qualifications include height to weight ratios, history of breast pain, back/neck pain, rashes under the breasts. attempted non surgical therapy like a chiropracter or anti inflammatory meds, letters from your primary... more

Insurance coverage for breast reduction.

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