Trying to find out what policiy various insurance companies have for determining coverage for a breast reduction. Most have some sort of chart for grams. I know it goes by height and weight. Female has a BSA of 2.06
June 18, 2010
Answer: Breast Reduction Amount
Most insurance companies if not all now do not simply use the 500 gm rule. Since height and weight matter, they use a sliding scale called the Schnur scale. This is based on your Body Surface Area. The heigher the ratio the more breast tissue that needs to be removed. The scale is amount per side.
Precertification is often obtained for breast reduction to see if your plan covers it.
Good luck.
Helpful
June 18, 2010
Answer: Breast Reduction Amount
Most insurance companies if not all now do not simply use the 500 gm rule. Since height and weight matter, they use a sliding scale called the Schnur scale. This is based on your Body Surface Area. The heigher the ratio the more breast tissue that needs to be removed. The scale is amount per side.
Precertification is often obtained for breast reduction to see if your plan covers it.
Good luck.
Helpful
June 18, 2010
Answer: Breast Reduction Amount
In actuality, most use 500g, no matter what your size and weight are. Sometimes you ahve to fight with them to cover people under 500g, but as long as you can provide medical documentation to back it up, usually you are OK. I have had coverage on someone who was 5'0 and only had 300grams removed. It just depends on your insurance company. Some never even ask to see the pathology weights after, while others want to see the operating report and weights removed. To be safe and avoid hassle, 500 grams is the magic number.
Helpful
June 18, 2010
Answer: Breast Reduction Amount
In actuality, most use 500g, no matter what your size and weight are. Sometimes you ahve to fight with them to cover people under 500g, but as long as you can provide medical documentation to back it up, usually you are OK. I have had coverage on someone who was 5'0 and only had 300grams removed. It just depends on your insurance company. Some never even ask to see the pathology weights after, while others want to see the operating report and weights removed. To be safe and avoid hassle, 500 grams is the magic number.
Helpful