Insurance Coverage for Tuberous Breast Reconstruction?

asked 3 years ago by SnoopBoob in Denver, CO
Latest answer by Steven Wallach, MD
Question viewed 2,246 times

I noticed only one doctor addressed the insurance coverage for "snoopy" or "tuberous" breasts. Is it common for most insurance companies to pay for the correction? Which insurance provider would be the best choice?

Any recommendations for surgeons in Colorado that are experienced with this condition? Thank you!

6 answers to Insurance Coverage for Tuberous Breast Reconstruction?

Insurance coverage for tuberous breast

In New York, insurance companies will not cover tuberous breast. I have tried many times to get it covered as it is a congenital anomaly, with no success. Every state is different but the likelihood it is covered in Colorado is probably low. The best way to find a plastic surgeon with expertise in this area is to get recommendations from other doctors such as ob/gyn, check with the American Board of Plastic Surgery to find board certified plastic surgeon, check with American Society of... more

Tracy Pfeifer, MD
Manhattan Plastic Surgeon

Less and Less Are Covering

In Pennsylvania the experience has been that less and less insurance companies have been covering the correction of these deformities. There is a better chance for coverage when you are younger rather than waiting until later in life. In addition severe, deformity that is unilateral will be more likely to be covered. It is always worth a try but ...

John P. Stratis, MD
Harrisburg Plastic Surgeon

Tuberour breasts and implants

I do not know of an insurance company that will cover tuberous breast deformities. It is usually deemed cosmetic.

Steven Wallach, MD
Manhattan Plastic Surgeon

Tuberous breast deformity and breast reconstruction

At this time, most insurance companies will deem a tuberous breast deformity a cosmetic concern and will not deny coverage. Although it is possible for you to appeal their decision.

Raffy Karamanoukian, MD
Los Angeles Plastic Surgeon

Tuberous breasts are a cosmetic and not a functional issue

I would not submit a tuberous breast procedure to an insurance company- its a cosmetic procedure with no functional benefit for the patient. Insurance companies are restrictive enough with breast operations that offer real benefit to patients (bilateral breast reduction, BRAVO study etc...) - they are going to deny any tuberous breast claim that is submitted. Your best option is to find a surgeon that is experiences with this difficult operation and obtain a price quote for the procedures more

Scott Sattler, MD
Bellevue Plastic Surgeon

Insurance companies tend not to cover tuberous breasts

I have had numerous cases of severe tuberous breast deformity aka constricted breasts denied by third party payors despite strong documentation and supporting letters from counselors, pediatricians, physical therapists, etc.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

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