Medicaid Coverage for Breast Reduction of a C and Dd Cup Breasts?

My right breast is DD and my left a C. I've struggled with this for 8 years. Doctors said they would catch up around when I turned 18 but they didn't and when I got pregnant the difference got worse; with the milk and then when it went away.

And now I'm having back pain, shoulder blade pain, and neck pain, and my skin underneath is off and on irritated, dry, peeling and theres red lines sometimes. And my sleeping is affected. I'm in desperate need of a Breast Reduction. But I don't know what to do with my insurance.

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breasts C cup DD cup pain uneven female asymmetry breast feeding breast size insurance pregnancy

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5 Doctor Answers | Asked by Katie826 in Indiana

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Insurance coverage for breast lift or breast reduction.

Insurance Coverage for Breast Reduction Answer by George J. Beraka, MDManhattan Plastic Surgeon80% 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

Medicaid Coverage for Breast Reduction of a C and DD Cup Breasts

The requirements for bilateral breast reduction coverage by Medicaid have always been so rigid as to make it almost impossible to have them agree to cover the procedure. If you could get it approved it will be hard to find a plastic surgeon to accept the fee that Medicaid pays for this procedure.

Breast Reduction and Medicaid?

Thank you for the question. Medicaid has been known to cover breast reduction surgery. For multiple reasons, most plastic surgeons that I know of to not work with Medicaid. I think finding a reputable plastic surgeon who will work with Medicaid will be the challenge you will face. Best wishes.

Breast reduction

Each insurance carrier has different criteria for pre-approval of a breast reduction. You should check with your insurance carrier.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Medicaid Breast Reduction

Medicaid will likely cover the procedure. Your problem may be finding a surgeon who will be willing to accept this as payment in full. It is quite difficult for surgeons to cover the costs of running their practice when reimbursed at these low rates.