How Do I Begin The Breast Reduction Process? (With Wanting Insurance to Cover the Procedure)

Based on your description you may be an excellent candidate for breast reduction surgery.   

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 are  consulting with a well-trained/experienced board-certified plastic surgeons.
 

When dealing with health insurance companies, be prepared to be persistent. Keep in mind, that breast reduction surgery tends to be one of the most patient pleasing operations performed.
 

Best wishes.

Contact your insurance to find out if you need a referral or if you can go directly to a plastic surgeon. Each insurance company has their own requirements as far as getting approval. Some will want you to have tried various methods for relief before approving surgery, such as physical therapy, good support bras, analgesics, etc. and they will want documentation of what you have tried. See a Board Certified Plastic Surgeon that specializes in breast surgery to help you go through the process of getting approval. If you should get denied, ask your surgeon to appeal your case, I have gotten many patients approved this way. Good luck!

Typically your PCP has to refer you to the specialist. They're the "gate keepers". Once referred, then ensure your plastic surgeon is well respected for this procedure. Many plastic surgeons no longer accept insurance for Breast Reduction surgery because of the poor re-imbursement given now a days. Sometimes patients prefer to pay out of pocket, there by allowing them to pick their plastic surgeon. Insurance plans force you to use the doctors on their plan... which may not be your choice.