Im 170 and 5'5 , Will Tricare Cover my Breast Reduction?

Im 170 and 5'5 and I wear a 36ddd. I have severe headaches and back and neck pain, my doctor prescribed me some meds to take everyday and I see a physical therapist and nothing is working. And now i experiencing numbness in my arm from the indents in my shoulder. Will tricare cover a breast reduction for me?HELP!!!

Doctor Answers 3

Breast Reduction - Will Tricare Cover my Breast Reduction?

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Unfortunately, there is a difference between whether or not they SHOULD, and whether or not they WILL.  It seems like you're a good candidate for the surgery; you've failed repeated courses of conservative therapy and you have relatively large breasts.  That should be enough.  But no one - aside from the insurance company itself - can say whether or not they will.  They use various formulas to compute how much tissue needs to be removed from each side in order to have it 'covered."   Their requirements may or may not be okay with you; they might want more tissue removed than you'd be comfortable with.  That's where you'll have to work with your PS.  Have him or her estimate how much tissue needs to be removed to achieve your goals, submit that to the insurance company, and see what they say.  That is actually the only way to get an answer to your question.

I hope that this helps and good luck,

Dr. E

Breast Reduction and Insurance Coverage?

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Based on your description you may be a good candidate for breast reduction surgery; it is one of the most patient pleasing operations would perform.
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 saying a well-trained/experienced board-certified plastic surgeon.

Best wishes.

Tricare and breast reduction

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See a board certified plastic surgeon in your area who accepts Tricare and bring with you all the documentation of the treatments you have already undergone. Based on the data you supplied, you should be a candidate for surgery. Your doctor will need to obtain preauthorization of benefits to confirm that Tricare will cover the procedure. Good luck!

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.