What Can I Do to Get a Breast Reduction?

Im 19 years old 160 pounds and 5'3" im a 36D and my back hurts alot and shoulders, i'm always slouching bc of it! I have MA ( blue plus) from the state dont know if it will cover a breast reduction. Will they take payments? Do i have to have money down? i just had a baby so i dont have much money.

Doctor Answers (5)

Breast Reduction and Insurance Coverage?

+1

Thank you for the question.
It sounds like  you are dealing with juvenile breast hypertrophy along with the physical and psychosocial consequences of this diagnosis. In other words, the breasts are too large for the frame causing  both physical and psychological distress.
As  you think  about  breast reduction surgery make sure you do your homework and understand the potential risks and complications associated with  the procedure.  Unsatisfactory scarring is  one of the potential complications. Make sure you also understands that further surgery may be necessary in the future (for example if the breasts were to grow in size again).
On the other hand, breast reduction surgery is one of the most patient pleasing operations we perform and I think that for the right teenager (enough symptoms) it may be an excellent option (regardless of the age).
Sometimes breast  reduction surgery is covered through health insurance. 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  working with a well-trained/experienced board-certified plastic surgeon.

I hope this helps.


San Diego Plastic Surgeon
5.0 out of 5 stars 756 reviews

Breast reduction and insurance and costs

+1

We get our patients pre-authorized for a breast reduction surgery. It sounds like you have enough breast tissue to remove to get qualified. If not, and you still wish to have a reduction, our cost with our temporary recession price reduction is about $6000 plus the anesthesologist and surgery center. We also offer financing options.

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.5 out of 5 stars 25 reviews

Will insurance cover your breast reduction

+1

I would identify and locate a physician that participates with this plan and then schedule a consultation. The physician can then prepare a predetermination of benefits letter to ascertain your level of coverage.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

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Breast reduction and insurance

+1

In surance coverage for breast reductions will vary from state to state. You should call your insurance company to find out their policy.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Insurance coverage for breast reduction.

+1

 Insurance Coverage for Breast Reduction

Answer by George J. Beraka, MD
Manhattan Plastic Surgeon
80% 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 covered.

3) Many policies will pay for breast reduction if 500 grams (a little more than a pound) or more are removed from each breast.

4) Some policies take your height and weight into account. So that if you are tiny, smaller reductions will be covered. Find out the details of your policy.

5) DON'T get too much of a reduction just to satisfy the insurance company. You will be unhappy with tiny breasts.

6) Your surgeon needs to request pre-certification IN WRITING, and attach as much evidence as possible.

7) Evidence includes letters from your internist, orthopedic surgeon, and/or chiropractor stating that breast reduction will relieve your symptoms.

8) Some companies require that you try "alternative treatments" such as weight loss and physical therapy first.

9) Don't give up. If the first request is denied, demand an appeal.

10) If there is no insurance, and you cannot afford to pay a private surgeon, go to the plastic surgery clinic of a teaching hospital. There, residents do the surgery under supervision, and the cost is minimal. In New York City, we train residents and fellows at Lenox Hill Hospital, and they do good work.
 

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 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.