Out-of-Pocket Cost for Breast Reduction Covered By Insurance?

What is the out of Pocket Cost of a Breast Reduction After Insurance Pays

Doctor Answers (4)

Breast Reduction and Expenses?

+1

Thank you for the question.

Each insurance company and policy will be different;  therefore, it is not possible to precisely predict what your “out of pocket costs” will be. For more accurate information, contact your insurance company directly.

Good luck with  the breast reduction procedure;  it is one of the most patient pleasing operations we perform.

 


San Diego Plastic Surgeon
5.0 out of 5 stars 727 reviews

Breast Reduction - Out-of-Pocket Cost for Breast Reduction Covered By Insurance?

+1

Hi deezy,

No way to give a simple dollar amount for that question....

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 company says is "usual and customary."  That may or may not be easy to do.  If you start with the surgeons who participate in the insurance company you'll be off to a good start.  If you'd rather use a different surgeon, and you have out-of-network benefits, you can contact the surgeon's office and see if he/she will accept that payment.  Once THAT has been accomplished, you can try to figure out how much additional payment, if any, would be required of you.

Either way, you'll need the help of a plastic surgeon to submit a letter of precertification (typically including your height, weight, bra size, specifics of any pain that you have and how your enlarged breasts affect your health and quality of life) and photos and to make sure that everything is set before you have the surgery.  You should, of course, meet with a few plastic surgeons to see what they recommend, and make sure you're informed about the procedure and its risks so that you can proceed knowledgeably.  If you do all of this you'll be most likely to have a result you'll be happy and comfortable with.

The insurance company may also ask you to lose weight and/or try conservative therapy before making a determination.

I hope that this helps, and good luck,

Dr. E

Alan M. Engler, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 150 reviews

Breast Reduction Cost After Insurance Pays

+1

Different insurance policies have different requirements. Before scheduling your surgery you should have your surgeon's office help you get pre-authorization which can sometimes take weeks to get. Assuming you will get approval your insurance company should be able to tell you exactly what your out of pocket expenses will be, if any. It has been my experience that if you have your insurance through your work, your Human Resources department can be a big help in getting your approval if the insurance company is slow to act.

Miguel Delgado, Jr., MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 30 reviews

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Insurance coverage for breast reduction

+1

Insurance coverage for breast reduction can often be a frustrating experience for both patient and physician.  It is best to receive a preauthorization prior to proceeding with the surgery.The patient's responsibility depends on co pays, and deductibles. Hope that helps.

Joshua Korman, MD
Mountain View Plastic Surgeon
5.0 out of 5 stars 5 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.