Each insurance company have developed their own criteria for breast reduction. Some require a specific BMI, some require a minimum volume of breast removal, some require breast removal based on BMI, etc, etc, etc.Seek out a Board Certified Plastic Surgeon who knows you companies requirements, they can then help you understand if it should be covered. Good LuckStephen M. Davis, MD, FACSGreen Hills Plastic SurgeryNashville, Tennessee
Thank you for the question. Generally speaking, breast reduction surgery is one of the most patient pleasing operations we perform. By removing “excess” breast tissue, adipose tissue, and breast skin this operation reduces AND lifts the breasts to a higher position on the chest wall (in other words, the breasts are "automatically" lifted when a breast reduction is performed). By doing so, patients often find improvement in neck, back, and shoulder discomfort and find it easier to form their activities of daily living and exercise. Obtaining insurance coverage for breast reduction surgery will likely involve 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 letters/pictures from your plastic surgeon will help you obtain authorization. Prepare to be persistent when dealing with health insurance companies.When the time is right, seek consultation with well-trained/experienced board-certified plastic surgeons. Ask to see lots of examples of their work and communicate your goals clearly.I hope this, and the attached link, helps. Best wishes as you work towards your goals.
