Will amerigroup cover an tummy tuck and breast reduction i am 5'0 even i weigh 174.6 pounds. (photo)

From your description it seems as if you are a good candidate for breast reduction. 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. Although we do not accept insurance, our staff will assist you in obtaining pre-authorization so that you can attempt to be reimbursed for out of pocket expenses

Thanks for the question.Generally insurance doesn't cover plastic surgeries. There is an option to make the procedure you want at an affordable cost, so you will not have to incur financial loans.In this regard, you have the possibility of getting a plastic surgery with high quality standards: with Board Certified Plastic Surgeons, in medical centers that follow international standards of patient safety and in comfortable and supervise recovery places after procedure, all for an affordable investment and reasonably lower than the standard values.In that sense I recommend considering coming to the Dominican Republic, its proximity to the US (45min).the "all year summer" and its political and economic stability, as a remarkable development, have made an excellent and safe destination for medical tourism and specially in Plastic Surgery, which it is already a global reference.Finally, i invite you to contact a Board Certified Aesthetic and Reconstructive Plastic Surgeon of the DR.Respectfully,Dr. Emmanuel Mallol Cotes.-

Thank you for the question and pictures.  Generally speaking, insurance companies do not cover tummy tuck procedures.Best to check directly with your insurance company to see whether breast reduction surgery is a “covered” benefit with your specific policy. Then, given that every insurance company has different “criteria”, best to identify exactly what your specific insurance company considers criteria for approval. Generally, 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. Also, for many insurance companies, the closer you are to your long-term ideal weight, the better.
This documentation and letter/pictures from your plastic surgeon will help you obtain authorization. Keep in mind, as you work towards your goals breast reduction surgery is one of the most patient pleasing operations we perform. Also, prepare to be persistent when dealing with health insurance companies. I hope this, and the attached link, helps. Best wishes.