Do most surgeons include lipo for under arm for a breast reduction?

I met for a conSult with PS weds. They have sent request in to ins. Company. I am a bit discouraged though He told me one month off work & basically couldn't do anything for that month) I also asked about lipo under the arm. He said was not included and ins. Definitely wouldn't pay for that. He also mentioned cutting the area, removing the fat and extra skin. Can either of these be done at same time as breast reduction? My concern is the pain level having both procedures at same time .