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Will Illinois Medicaid Cover Breast Reduction of G Cup Breasts?

asked 2 years ago by amc1234 in Illinois- st.louis, mo
Latest answer by Alan Engler, MD
Question viewed 1,377 times
Tags: age 25-34, breasts, female, 5 ft 0 in to 5 ft 3 in, after pregnancy, sagging, back pain, DDD cup, E cup, G cup, insurance, pain, pregnancy

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?

5 answers to Will Illinois Medicaid Cover Breast Reduction of G Cup Breasts?

+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
Alan Engler, MD

New York Plastic Surgeon
+1

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
Tom J. Pousti, MD

San Diego Plastic Surgeon
+1

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

Manhattan Plastic Surgeon
+1

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
George J. Beraka, MD

Manhattan Plastic Surgeon
+1

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
Peter A. Aldea, MD

Memphis Plastic Surgeon

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