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Breast Lift Paid Under Medicaid Insurance?

I have large breast and after having my kids it sag down. When I take my bra off I feel my breast weighting me down. When I have a bra on The weight does not bother me. I have medicaid insurance and would like to know if there is somewhere I can go in the nyc area to get a breast lift that would be cover under my insurance? I wear a 34 DD size bra.

Doctor Answers 7

June 29th, 2009

Has to be deemed medically necessary

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The first step is to contact plastic surgeons in your area and see who accepts Medicaid. Set up an appointment for a consultation with that physician to see if it is a breast lift or breast reduction that you are needing. If it is a reduction not a lift then the surgeon can submit a letter to Medicaid stating how many grams of tissue he will be removing and why he feels it is medically necessary to remove the breast tissue.

Go prepared by taking all information that will support your case such as past medical information such as chiropractic care due to back pain (due to the heaviness of the breasts) or Doctors notes from past visits regarding fungal infections in the folds of the breasts. If it is only a breast lift that you need insurance will not pay for that procedure.

Vincent N. Zubowicz, MD
June 28th, 2009

Breast Lift vs reduction

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I am confused by your post. It appears to be that you want a breast reduction or need one but you are asking for a breast lift. A breast lift for sure would not be covered and a breast reduction under medicaid insurance may or may not be covered, but you will not find any plastic surgeons who would be willing to do this surgery under medicaid.

Good luck.

Learn more: http://www.feplasticsurgery.com/orange-county-breastlift-newport-beach.php

Farbod Esmailian, MD
October 22nd, 2014

No, but breast reduction can be covered

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Insurance doesn't usually cover the cost of a breast lift, but you should contact your insurance provider to find out if yours is covered. If it is, it would have to be deemed medically necessary. 

From the sounds of it, though, you may be suitable for a breast reduction (a lift may be performed simultaneously). Breast reduction can be covered by insurance, but again, please contact your provider.

Learn more: https://plus.google.com/+Edelsteincosmetic

Jerome Edelstein, MD
February 5th, 2012

Breast Lifting and Insurance Coverage?

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Thank you for the question.
No, insurance companies do not provide coverage for breast lifting surgery. They do however sometimes provide coverage for breast reduction surgery.
Best wishes.

Learn more: http://www.poustiplasticsurgery.com/Procedures/Procedure_breastLift.htm

Tom J. Pousti, MD, FACS
May 14th, 2010

Breast lift surgery and Medicaid.

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Breast lift surgery that removes a small amount of tissue alone is not covered by insurance plans. If you have very large breasts, the most important thing is to be evaluated by your primary care provider who will be able to document that you have pain and other symptoms from the breasts. You may then be evaluated by a plastic surgeon who can determine how much tissue needs to be removed to help alleviate your symptoms. Contact your primary care physician as they will have a list of the surgeons who performed the surgery and accept Medicaid

Pat Pazmino, MD, FACS
March 7th, 2010

Breast lift and/or reduction with insurance

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First it is a matter of what you want. If you like the volume and want a lift, insurance will not cover it. If you want a reduction in volume because of symptoms such as bra strap grooving, back and neck pain, your insurnace company may cover it. You have to contact your insurance company to find out their requirements.

Steven Wallach, MD
June 28th, 2009

Without Medical Problems You Won't Get Covered

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A breast lift only would be considered cosmetic, although if you have neck, back, or shoulder problems and a very large breast you could get covered.

John LoMonaco, MD, FACS

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.