Breast Lift Paid Under Medicaid Insurance?

Question

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.

Jerome Edelstein, MD · Answer

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.

Thomas Trevisani, MD · Answer

Medicaid is a tax payer funded health care insurance . Tax payers are not obligated to pay for your breast surgery. The best answer is- to get a good job, save the money and pay for it like every one else does.

Vincent N. Zubowicz, MD · Answer

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.

John LoMonaco, MD, FACS · Answer

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.

Farbod Esmailian, MD · Answer

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.

Tom J. Pousti, MD · Answer

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.

Pat Pazmino, MD, FACS · Answer

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

Steven Wallach, MD · Answer

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.

Breast Lift Paid Under Medicaid Insurance?

Answers (8)

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