Insurance Worry for Breast Reduction. Do You Think I Will Be Approved?

Hi everyone, i am a 20 year old college student. I have a breast reduction scheduled for may 25th. Even though i have not been approved yet , my ps scheduled me because i am in a time crunch since im home from college to work for the summer. I went in on april 2nd for a consult and it has been about 4 1/2 weeks. Im getting more nervous every day that i wont be approved. I have double upmc insurance. I am 5'3 , 175 pounds, athletic and very top heavy. Do u think i will be approved? I am a DDD.

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4 Doctor Answers | Asked by ylime232

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Insurance approval

At 5'3 and 175 lbs, your body surface area is 1.87 meters squared. If you have Aetna insurance, they would require 740 grams removed. If you are 32 or 34 then each cup size corresponds to 100 cc's, if you are 36 or 38 then each cup size corresponds to 200 cc's and if you are 40 or 42 then each cup size corresponds to 300 cc's. Using this information, you can predict the size you would end up, which may or may not be satisfactory. Also, insurance... more

Insurance Approval for Breast Reduction?

As much as I would like to be able to provide you with reassurance, only communication with your insurance company will be helpful in doing so. It won't hurt for you to call the insurance company; hopefully you will be able to make contact with a helpful person who can tell you the status of your “authorization”. Best wishes.

Breast reduction approval

I think that you have good cause to be a bit nervous. Most insurance companies respond within a few weeks and almost all within a month of the request being issued. I would simply call your insurance company and ask for a status update on your case. You are going to have to endure a few voice prompts, but it will be worth finding out for sure. Even though your surgery is scheduled, I doubt that your surgeon will perform your surgery before there is either an approval from the insurance... more

Breast reduction approval

The only party who can tell you whether you'll be approved is the insurance company. In NY, there is a time parameter within which they must approve or deny a case and, even so, they do not adhere to the statutory guidelines. Here, you could likely be denied because of BMI and being overweight unless, for some companies, you had extremely well documented unsuccessful medical management, including physical therapy or chiropractic for 3-6 months, pain medication, orthopedic workup, etc. ... more