Will Illinois Medicaid Cover Breast Reduction of G Cup Breasts?

I'm 5'1", 28 years old and have always had large breasts. My bra size right out of high school was 36DDD. That was 10 years and 2 children ago.

After my first child my breasts grew and stayed at 40E. Now my second child is 6 months old and my breast have become even bigger, 40G.

They have always sagged and my right breast has always been larger. I could live with that, but along with it has been chronic back and shoulder pain, grooves where my straps are, neck pain. Will insurance cover surgery?

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age 25-34 breasts DDD cup E cup G cup pain sagging female 5 ft 0 in to 5 ft 3 in after pregnancy back pain insurance pregnancy

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5 Doctor Answers | Asked by amc1234 in Illinois- st.louis, mo

Doctor Answers (5)
Community Comments (1)

Breast Reduction - Insurance Coverage

Probably, but you cannot assume that and, regardless, there are still some issues. Each insurance company is different, and each has its own rules with respect to "coverage." It used to be that a 500 gram reduction (from each side) would be enough to qualify for insurance coverage, but that is no longer the case and cannot, in any event, be assumed to be the case. You'll first have to contact your company to make sure it's covered, and then you have to find a... more

Breast reduction insurance coverage

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. Make sure you're saying a well-trained/experienced... more

Insurance coverge for breast reduction

Every insurance company is a bit different with regards to coverage for a breast reduction. You should contact your insurance company to find out their criteria.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

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" of Breast Reduction

We need to clarify some terminology. Medicaid is notoriously difficult in approving / IE COVERING Breast Reduction surgery. So a lot of time would need to be spent writing them and documenting your situation. But - worse yet even if they "cover" (IE approve the surgery and agree to pay for it), the amount they pay the surgeons for this surgery is often preposterously too low. As a result, many surgeons prefer not to see Medicaid patients who approval process is frustrating and... more

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Comments (1)

Missy926 7 May 2013

If you are having back pains neck pain numbness rashes shoulder pains head achs and if you are under a doctors care for this.. Your Insurance conpany will want you to try to get treatment. They will want you to have testing done emg testing mri testing x rays.... You must prove that your breast is the sole reason for your pain..... Oh yeah you will need to see a back doctor chiropractor and physical therapy... You may get denied the first time BUT don't give up..... Good luck.

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