Will my Insurance Pay for Breast Lift?
Doctor Answers 77
Insurance for breast lifts?
A "breast lift" or mastopexy is a cosmetic operation and will not be covered by insurance. The mastopexy is designed to recontour the breast so that the tissue and the breast skin envelope are a better match, i.e. that they produce a more projected and uplifted breast.
A "breast reduction" in a literal sense would not provide a lift, but the way most breast reductions (except the "scarless" or liposuction reduction) are done would provide a lift as well. A breast reduction, however, is more of a functional operation to relieve back pain, intertrigo, and other health problems associated with larger breasts. If you have any of these problems and your breasts are large enough to require a reduction, your insurance company may pay for a breast reduction.
Insurance doesn't cover breast lifting
There isn't any coverage available for breast lifting as it is considered not medically necessary. The only way insurance would be involved in a lift is if it were part of a full breast reduction.
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Insurance Does Not Consider Breast Lifts Medically Necessary
It is always good to get insurance to help with coverage of plastic surgery when it is possible. However insurance plans are quite strict about excluding an operation that is more for appearance than function. A breast lift improves breast shape, but there is no scientific proof that it improves mobility, back pain or shoulder pain. A "mastopexy" would be an excluded procedure.
Insurance Does Not Cover Breast Lift BUT Does Cover Breast Lift & Breast Reduction Combined
Insurance carriers will not pay for breast lift surgery. Occasionally, patients requesting breast lift may also have an element of breast hypertrophy. Under these circumstances, a breast lift in combination with a small breast reduction may be a covered expense.
This depends entirely on the insurance company’s criteria for weight of tissue removed. To make these determinations, a consultation is necessary and if the insurance company does not cover the procedure, a cosmetic fee quote for breast lift can be obtained.
Insurance companies won't pay for a breast lift
Although many insurance companies pay for breast reductions, they certainly do not pay for breast lifts (mastopexy). A breast lift is a cosmetic procedure that is performed to treat sagging or droopiness of the breasts. During a typical breast lift procedure, excess breast skin is removed, the areola is made smaller, and the nipple position is raised to a more appropriate level.
Insurance and a breast lift
In most cases, a breast lift (mastopexy) will not be covered by insurance. It is usually considered a cosmetic procedure and cosmetic procedures are rarely covered by insurance. If a breast reduction is performed, a breast lift is achieved as well. Breast reductions can be covered by insurance depending on the insurance plan and how much the breasts are reduced. In breast cancer reconstruction, a breast lift will be covered to help match breast size/shape.
Insurance Won't Pay for Cosmetic Procedures
Because breast lift is for improving the appearance of the breast and doesn't repair an abnormality, health insurance will not cover costs for breast lift.
Insurance coverage of breast lift procedure
These are some conditions where the insurance will cover breast lift:
- Congenital deformity such as to make the breast symmetric and Tuberous breast deformity
- As part of breast reduction for large breasts
- Reconstrucitve options such as after cancer reconstructions
Most often they are not covered. A lot depends on the insurance plan and sepcific coverage.
Hope this was helpful.
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.