If I Want to Reduce and Lift my 38 F Size Bra to 38 C is Insurance Bc/ Bs Cover It?

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6 Doctor Answers | Asked by cecerem

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Breast Reduction Insurance Coverage Factors

Insurance Criteria for Breast Reduction Varies between Companies but going from an F to a C cup would most likely qualify for the minimum weight of breast removal. Insurance Criteria for approval for Breast Reduction varies from insurance company to insurance company. Contact your individual company and request their specific Criteria. Insurance company favors approval for patient with functional problems like the ones you mentioned - back, neck and knee problems, bad posture, inability... more

Insurance coverage and breast reduction surgery

Every year is is harder to get insurance to cover breast reduction procedures. This is true even with significant reductions of several cup sizes. Based on your description, it is certainly worth a try. One thing that many patients don't realize, is that within a big insurance company in a given geographic area, there may be hundreds of different plans, each with different rules. You need to obtain the specific rules that pertain to your... more

Breast reduction and insurance coverage

Based on your description this is very likely. Breast reduction will include a breast lift. After you have had an examination and if your surgeon feels this is a medically necessary procedure, he or she will contact you insurance company to get preuthorization for insurance coverage.

Breast reduction

Each insurance company will have different criteria to approve breast reductions. This may include medical notes from treating physicians for back and neck pain, your surgeon's notes, photos, and estimates of breast weight removal.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Breast reduction coverage

Insurance criteria take into account your height, weight, conservative medical management, underlying complaints and other factors. If you have BC/BS of NJ, know that they are particularly strict, especially about medical management for up to one year and weight within 10% of their standard, which is based on 1950s calculations. You should be able to review the insurance criteria online and then to ascertain whether you have fulfilled the requirements.

Breast Reduction and Insurance Coverage?

Based on the description of breast size you may be an excellent candidate for breast reduction surgery. If you are not at a long-term stable weight, it will be in your best interest to achieve this before undergoing breast reduction surgery. Whether or not the breast reduction procedure is covered by your insurance company will depend on the specific insurance company and your policy. You will need to check with them directly. The best way to obtain insurance coverage for breast... more