I was wondering how likely it would be for insurance to cover a breast reduction for me. I'm 5'6", 135 pounds, and a 32g. I have chronic back and neck pain. Where my back and neck connect will frequently go numb if I am standing for long periods of time. Also, if insurance were to cover a breast reduction, how much would the doctor be required to remove. Ideally, I'd like to be a full C cup. Who's this be possible?
Answer: Will Insurance Cover BR Surgery? Unfortunately, each insurance company has their own criteria. Large breasts (macromastia) or breast hypertrophy can occur in a variety of conditions (family trait, post pregnancy, excessive adolescent growth). In general when the excessive breast size causes functional problems, insurance will generally pay for the operation if more than 400 – 500 grams are removed from each breast dependent on your individual insurance company requirements. These problems may include neck pain, back or shoulder pain, hygiene difficulty, and breast pain. Other problems which are less likely to be covered by insurance include skin irritation, skeletal deformity, breathing problems, psychological/emotional problems, and interference with normal daily activities. Pre-authorization by the insurance company is required prior to surgery, and the process takes approximately one month. Each insurance policy has different guidelines and exclusions. This procedure is commonly covered by insurance through insurance criteria are becoming more and more restrictive
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Answer: Will Insurance Cover BR Surgery? Unfortunately, each insurance company has their own criteria. Large breasts (macromastia) or breast hypertrophy can occur in a variety of conditions (family trait, post pregnancy, excessive adolescent growth). In general when the excessive breast size causes functional problems, insurance will generally pay for the operation if more than 400 – 500 grams are removed from each breast dependent on your individual insurance company requirements. These problems may include neck pain, back or shoulder pain, hygiene difficulty, and breast pain. Other problems which are less likely to be covered by insurance include skin irritation, skeletal deformity, breathing problems, psychological/emotional problems, and interference with normal daily activities. Pre-authorization by the insurance company is required prior to surgery, and the process takes approximately one month. Each insurance policy has different guidelines and exclusions. This procedure is commonly covered by insurance through insurance criteria are becoming more and more restrictive
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May 9, 2015
Answer: Breast Reduction - Insurance Coverage? See my previous answers on this topic. This answer is difficult to answer without knowing what type of medical insurance coverage you have. You should call your insurance company to discuss their policy regarding breast reduction to see if they cover it. You do sound like a candidate for a breast reduction and a Board Certified Plastic Surgeon can probably accomplish your size goal. It is difficult to tell you how much tissue they will excise or even if you are a candidate for insurance coverage without an examination. So find a plastic surgeon in your area to discuss this with. #BreastReduction #PlasticSurgery #Macromastia #Medicalinsurancecoverage
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May 9, 2015
Answer: Breast Reduction - Insurance Coverage? See my previous answers on this topic. This answer is difficult to answer without knowing what type of medical insurance coverage you have. You should call your insurance company to discuss their policy regarding breast reduction to see if they cover it. You do sound like a candidate for a breast reduction and a Board Certified Plastic Surgeon can probably accomplish your size goal. It is difficult to tell you how much tissue they will excise or even if you are a candidate for insurance coverage without an examination. So find a plastic surgeon in your area to discuss this with. #BreastReduction #PlasticSurgery #Macromastia #Medicalinsurancecoverage
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January 21, 2019
Answer: Breast Reduction and Insurance From your description you should qualify for a breast reduction, however it will depend on your particular insurance policy. Insurance companies have guidelines that they follow and they are not all the same. The best way to find out is to contact your insurance company, or see a Board Certified Plastic Surgeon who can help you apply for benefits. Most insurance companies require a minimum of 500cc needed to be removed from each breast. Good luck!
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January 21, 2019
Answer: Breast Reduction and Insurance From your description you should qualify for a breast reduction, however it will depend on your particular insurance policy. Insurance companies have guidelines that they follow and they are not all the same. The best way to find out is to contact your insurance company, or see a Board Certified Plastic Surgeon who can help you apply for benefits. Most insurance companies require a minimum of 500cc needed to be removed from each breast. Good luck!
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April 28, 2015
Answer: Insurance and breast reduction Everything you wrote sounds like you are a very good candidate for breast reduction surgery covered by your insurance company As long as you are non-smoking, you should be able to achieve a good outcome. Insurers differ in their requirements The best way to find out what yours requires for breast reduction surgery is to research your policy on their website The procedure code or cpt code for breast reduction surgery is 19318. The diagnosis is symptomatic macromastia icd9 code 611.1. Most insurers require a minimum amount removed based on a scale that uses your body surface area. Other things some insurers require are supporting documentation of rashes or musculoskeletal pain relief measures treated from physical therapist, chiropractor or other physician. This is part of the 'conservative measures' that insurers like to see documented before approving the breast reduction surgery Your plastic surgeon's office should help guide you through this process but a little leg work on your own will also streamline the approval process Good luck You will not regret the decision to have breast reduction surgery. The most common comment I hear from my patients is 'why didnt I get this done sooner'.
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April 28, 2015
Answer: Insurance and breast reduction Everything you wrote sounds like you are a very good candidate for breast reduction surgery covered by your insurance company As long as you are non-smoking, you should be able to achieve a good outcome. Insurers differ in their requirements The best way to find out what yours requires for breast reduction surgery is to research your policy on their website The procedure code or cpt code for breast reduction surgery is 19318. The diagnosis is symptomatic macromastia icd9 code 611.1. Most insurers require a minimum amount removed based on a scale that uses your body surface area. Other things some insurers require are supporting documentation of rashes or musculoskeletal pain relief measures treated from physical therapist, chiropractor or other physician. This is part of the 'conservative measures' that insurers like to see documented before approving the breast reduction surgery Your plastic surgeon's office should help guide you through this process but a little leg work on your own will also streamline the approval process Good luck You will not regret the decision to have breast reduction surgery. The most common comment I hear from my patients is 'why didnt I get this done sooner'.
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April 28, 2015
Answer: Insurance Every insurance plan has their own unique criteria on whether they will
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April 28, 2015
Answer: Insurance Every insurance plan has their own unique criteria on whether they will
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