I'm a J Cup with Constant Neck Shoulder Pain. How Can I Get Insurance to Pay Some?

asked 4 months ago by mrs.smith319710 in Albany, OR
Latest answer by Stewart Wang, MD
Question viewed 186 times
Tags: insurance, j cup

little about me I'm 5ft 7in 175lbs mother of 2. I have always had large breasts making sports horse ridding everything even cook standing painful to neck and upper back frequent migraines too. Well after 2 kids I'm now at a h-j cup size and can't find a 36 h or j bra and I'm so frustrated. I'm working on getting down to a ideal weight for me 150 then considering reduction. How can I get insurance to pay or help pay for this surgery? Also will they do a lift when they reduce or is the separate?

11 answers to I'm a J Cup with Constant Neck Shoulder Pain. How Can I Get Insurance to Pay Some?

Breast Reduction and Insurance Coverage

It is possible that your health insurance will cover some the cost of your breast reduction surgery but you will have to check with your insurance carrier to see if it’s a covered benefit. Next, search for a qualified plastic surgeon who is a participating provider. Most likely you will need to obtain a pre-authorization from your insurance carrier prior to your surgery. Each insurance carrier will have different set of criteria and documentation before authorizing a breast reduction... more

Stewart Wang, MD
Los Angeles Plastic Surgeon

Insurance Coverage for Breast Reduction Surgery

It sounds like you would be a great candidate for breast reduction surgery, however it depends on what insurance policy you have. You should contact your insurance company to find out what their guidelines are for coverage as they can vary. Most insurance companies require a minimum of 500 grams from each breast be removed, but many also want documented steps that you have taken to help your condition, such as: good support bras physical therapy analgesics weight... more

Miguel Delgado, Jr., MD
San Francisco Plastic Surgeon

www.dr-delgado.com

Breast reduction coverage

From the information that you provided it appears that you would greatly benefit from a breast reduction. This may very well be covered by your insurance company. However, you first need to make sure that it is a covered benefit as several do make exclusions for coverage. The second is to find the list of the criteria for coverage which usually includes conservative therapy such as physical therapy (which as expected, is never a long term solution). You need to see a board certified... more

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon

www.turkeltaub.com

Breast reduction and insurance coverage

I know, as do my patients, that no amount of physical therapy, chiropractic therapy, or special bras will make your large breasts smaller or easier to manage! Many insurance companies will cover breast reduction surgery. However, a lot of insurance companies really do make patients "jump through the hoops" before authorizing the operation. Many insurance carriers require that a patient has: Documented symptoms for 6-12 months recorded in a... more

Joshua Cooper, MD, FACS
Seattle Plastic Surgeon

Insurance coverage for breast reduction

At your bra size, you have gigantomastia and your insurance will probably pay for the surgery. What is required is a letter of preauthorization from a plastic surgeon, accompanied by photographs and a statement of failed conservative medical modalities. Your insurance company should have its breast reduction criteria posted on its website. The breast reduction is inclusive of a lift. I recommend that you see a board certified plastic surgeon who is participating in... more

Robert L. Kraft, MD
New York Plastic Surgeon

www.foresthillsplasticsurgery.com

Insurance coverage for breast reduction.

I hope you find this article useful. 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... more

George J. Beraka, MD
Manhattan Plastic Surgeon

Breast reduction

You may be an excellent candidate for breast reduction but withotu an exam it is dificult to say. As for insurance coverage, it is getting tougher and tougher. Each insurance company works differently and you have to aske them what their criteria are.

Steven Wallach, MD
Manhattan Plastic Surgeon

Breast reduction and insurance coverage

A breast reduction will definitely help alleviate some of your symptoms including the back pain, neck pain, and headaches. However, each insurance company and each policy has different criteria on what is considered medically necessary. I would check with your insurance carrier and your specific policy regarding what criteria will need to be met so that your breast reduction will be paid for by insurance. Once you have chose a board certified plastic surgeon, his/her office... more

Anureet K. Bajaj, MD
Oklahoma City Plastic Surgeon

Lift Is Part Of Normal Breast Reduction

Your health insurance is likely to cover a breast reduction in your case unless there is an outright exclusion which some policies contain. Tightening the skin envelope to lift the breasts is a part of all standard breast reduction techniques and you should not be charged additionally for this.

John Whitt, MD
Louisville Plastic Surgeon

Breast Reduction and Insurance Coverage?

Congratulations on your decision to look into breast reduction surgery; it is one of the most patient pleasing operations we perform. You are also wise to achieve a long-term stable weight prior to proceeding with the operation. This will minimize the chances of further surgery will be necessary in the future ( related to weight gain/loss issues). Obtaining insurance coverage for breast reduction surgery involves some “hoops” to jump through. The more documentation you... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

Insurance coverage for breast reduction

It sounds like you would be an excellent candidate for breast reduction, and I support your plan of working toward your goal weight prior to having the procedure done. For someone with your breast size, a breast lift would be included as part of the procedure. Regarding insurance coverage: check the exclusions page of your policy - if breast reduction is listed it will not be covered you should be able to obtain your insurance carrier's clinical policy... more