Will my medicaid pay for a breast reduction? (photo)

Question

Hi, I will like to know if medicaid will pay for a breast reduction. How do i go about getting a breast reduction? I'm 21 years old and my breast have been huge since I've been in the 9th grade. I get rashes alot and also have bad back pains and bra straps make indentions in my skin. Thanks.

Randal Haworth, MD, FACS · Answer

With today's insurance plans under the ACA, less and less insurance companies cover breast reduction surgery despite that you may have symptoms such as painful bra strap grooving, neck, shoulder and back pain overly large breasts. However, I suggest contacting your insurance company and asking exactly what is and isn't covered in regards to treating macromastia with a breast reduction.  If they do offer coverage then ask for a list of in network providers whom you can then contact to set up an appointment and consultation with to address your concerns.

Leila Kasrai, MD, FRCSC · Answer

Insurance may cover your surgery if it is deemed medically beneficial for you. To determine this, you should consult with your GP and board certified plastic surgeon.

Gary M. Horndeski, MD · Answer

Hi,The Horndeski Method/The Bellesoma Method is a current technique to lift and/or reduce breasts without using implants or the ugly vertical scars.  The incisions are hidden around the areola and in the inframammary crease. The vertical incision has been completely eliminated. The areola incision heals almost invisibly due to the fact that there is hardly any tension on the closure. With this particular technique, ducts are preserved along with nerve supply maintaining nipple sensation and the ability to breast feed. Because the breast is reshaped internally and is secured to your chest muscles, upper pole fullness is possible without an implant. Attached is a patient who underwent The Horndeski Method/The Bellesoma Method. Please note that her tissue was used to create upper pole fullness and cleavage without any foreign materials (mesh, implants, etc).  Unfortunately, we do not accept insurance for breast reductions.  Dr. Horndeski does not remove enough breast tissue to meet insurance criteria.  Instead, he utilizes the breast tissue to reshape the breast.  It is a proprietary technique that only surgeons that have been trained by me can perform. I hope this helps. Best wishes and kind regards, Dr. Gary Horndeski

Nick Masri, MD, FACS · Answer

Insurance coverage is available for procedures considered medically necessary. They want to know that your condition is having or may have a negative  affect on  your health . Most women with large breast have problems with neck, back, shoulder pain , bra strap grooving, skin irritation, and so on. All of these issues are probably very well known to you. 
In most cases insurance companies, including medicaid, want to know that you have tried more conservative treatment to alleviate your symptoms. Did you lose weight, do you excercise to strengthen your back muscles, do you use appropriate support bras, are you using powders and creams to treat skin issues?
If these treatments have failed, and it has been documented appropriately by your family physician or internist, then your insurance/ medicaid should cover the procedure. 
First you should see your doctor. He/she will offer conservative treatment options. They will then refer you to a plastic surgeon who is a medicaid provider. You will see that board certified plastic surgeon who will them submit a request for authorization to medicaid. I hope this helps. Best Wishes

Karen Quigley, MD · Answer

There is no doubt that you would benefit from a breast reduction. It is hard to get this covered by Medicaid but each state it different and not all plastic surgeons accept Medicaid. You might check with a medical center that has a plastic surgery residency. They are usually on Meidcaid. Good luck.

Will my medicaid pay for a breast reduction? (photo)

Answers (5)

Answer: Is Breast Reduction covered by Medicaid

Answer: Is Breast Reduction covered by Medicaid

Answer: Breast reduction under medicaid

Answer: Breast reduction under medicaid

Recommended reading

Everything you need to know about Breast Reduction

Our mission is to create a world where every investment in modern beauty is Worth It.

Will my medicaid pay for a breast reduction? (photo)

Answers (5)

Answer: Is Breast Reduction covered by Medicaid

Answer: Is Breast Reduction covered by Medicaid

Answer: Breast reduction under medicaid

Answer: Breast reduction under medicaid

Browse related questions

Recommended reading

Everything you need to know about Breast Reduction

Our mission is to create a world where every investment in modern beauty is Worth It.