Will insurance cover my breast reduction if I get clogged pores, skin tags, and back pain; and what are the requirements?
Doctor Answers 3
INsurance Covering Breast Reductions
The companies make a distinction between "large breasts" and "abnormally large breasts" - even if a woman with only "large" breasts has significant back, neck, and shoulder pain. Sadly our health insurance industry is profit, not patient driven. The companies profit by denying care to the patients.
Will insurance cover my breast reduction?
Thank you for the question.
Based on your description, you may be an excellent candidate for breast reduction surgery. This operation tends to be one of the most patient pleasing operations we perform.
You will need to check with your insurance company directly to see whether your policy covers this operation. They will also be able to tell you whether you will have any direct responsibility/expenses if you choose to undergo this procedure.
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 surgeon will help you obtain authorization.
I hope this, and the attached link, helps.
Breast reduction preauthorization
They have gotten so strict that they won't accept a letter from the physical therapist; we have to hand in all the chart notes, too. Clearly, the insurance companies are looking for every excuse to deny surgery. Skin tags, clogged pores, etc. would not be considerations leading to approval.