Breast Reduction Q&A
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Could I Pay the Portion of my Breast Reduction That my Insurance Does Not Cover?

asked 1 year ago by hotchickwuzup in westbabylon,new york
Latest answer by Tom J. Pousti, MD
Question viewed 256 times
Tags: insurance, options, payment plan

I need a breast reduction because my breasts are weighing down my shoulder's and giving me back pains but, i wanted to know if my insurance does not cover the entire procedure could i pay the rest of the procedure out of pocket or a payment plan?

11 answers to Could I Pay the Portion of my Breast Reduction That my Insurance Does Not Cover?

+1

Insurance coverage of Breast Reduction Surgery

Thank you for your question. From my experience, the insurance companies either "approves" the surgery (they will cover the costs) or they "deny" the surgery (will not cover any costs of the surgery). I haven't heard of insurance company only covering certain portions of the procedure. Best to call your insurance and ask. Best wishes!
Tom J. Pousti, MD

San Diego Plastic Surgeon
+1

Breast Reduction Surgery

In most cases, insurance either covers the breast reduction surgery or they do not. It is not the usual case for them to say that they will only cover a portion of the surgery. My advice would be to call your insurance company and inquire about their criteria for breast reduction coverage. Then you will be better informed about whether to even try having them cover the procedure. Good Luck.
David Shafer, MD

New York Plastic Surgeon
+1

Breast Reduction - Could I Pay the Portion of my Breast Reduction That my Insurance Does Not Cover?

Hihotchickwuzup, Maybe - but it's not necessarily that simple. There are many issues with respect to insurance (you can always pay for the surgery on your own, but that may not be necessary. Or desirable!). Each insurance company is different, and each has its own rules with respect to "coverage." You'll first have to contact your company to make sure it's covered, and then you have to find a surgeon who will accept the payment the insurance... more
Alan Engler, MD

New York Plastic Surgeon
+1

Breast reduction surgery

Insurance coverage for breast reduction has gotten tougher and tougher. In many cases they will cover a portion of it, if and only if they initially cover it based upon their specific criteria. Some insurance companies demand 6 months documentation of attempt of treatment of back, neck and shoulder pain, and then require a certain minimum volume of breast tissue to be removed. Good luck.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Payment for breast reduction

If breast reduction surgery is approved by your insurance company, you have the option of selecting an in network surgeon in which case your out of pocket expense will be fairly small and consist of any deductable and copayment. Your doctors staff will be able to tell you exactly how much that will be. If you select a surgeon who does not participate with your insurance or one who is out of network then you will be resposible for a larger amount, that is the... more
Beverly Friedlander, MD

Short Hills Plastic Surgeon
+1

Can I pay?

The answer to that question is always: yes you may. what you work out with your surgeon is between the two of you. good luck. remember there are no absolutes, just routines that offices follow. find the doctor and office that makes your out of pocket reasonable. you paid for insurance you should try to use it. p.s. I am not a participating physician on any plans. when a pt sees me for a breast reduction, I quote them a fee and help with submission of claim. As a courtesy,... more
Rafael C. Cabrera, MD

Boca Raton Plastic Surgeon
+1

Breast reduction

As with most surgical procedures that are medically necessary insurance will only cover a portion. You will needn't pay the balance.
David L. Abramson, MD

New York Plastic Surgeon
+1

Sort of

If the physician you use is not a participating member in your insurance, you and he will determine what you pay. In my practice, I set my fees, you pay me and we bill the insurance Company. What ever they pay, you get. Each plan is different, most will NOT tell you in advance what they will pay, and some won't even guarantee any payment. Thus, I do most reductions in my own office or to keep down your costs.
William B. Rosenblatt, MD

New York Plastic Surgeon
+1

Could I pay a portion of my breast reduction?

Insurance companies either authorize and cover for your breast reduction or not . Of course you will be responsible for tha applicable co-pay or meet your deductibles .if it is not covered by your insuranse company you can finance your surgery through Care Credit or ask your plastic surgeon if they have any payment plans.
Fereydoon S. Mahjouri, MD

Minneapolis Plastic Surgeon
+1

You can pay the difference between what the insurance pays and what they approve for breast reduction

Yes you can pay the deductible and the percentage that your insurance does not pay. You can pay with credit card or check or you can finance it if you have a good credit history,and usually your insurance will let you know if they approve the surgery.
Gloria de Olarte, MD

Pasadena Plastic Surgeon
+1

Could I Pay the Portion of my Breats Reduction That my Insurance Does Not Cover?

In its own surrealistic logic the insurance system is fairly simple. For you to have a Breast Reduction under your policy the operation has to be APPROVED by your insurer. No approval = No surgery. Once the insurance company approves the operation, the surgeon, anesthesiologist and the hospital agree to be paid the fee they previously negotiated with your insurer (Even though in most cases it was a "take it or leave it" "negotiation"). The insures never pay the entire... more
Peter A. Aldea, MD

Memphis Plastic Surgeon

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