Can I Get Breast Reduction Covered by Medicaid?

Thank you for the question.

It sounds like you are dealing with   breast hypertrophy along with the physical and psychosocial consequences of this diagnosis. In other words, the breasts are too large for the frame causing  both physical and psychological distress.


I would suggest you do your homework and understand the potential risk and complications associated with breast reduction surgery, including  abnormal scarring. You also understand that further surgery may be necessary in the future (for example if the breasts were to grow in size again).

Timing of the breast reduction surgery is  based on  the patient's psychosocial place in life and is a very individual- specific decision.  She must be able to accept the scars (which result from the breast reduction surgery)  in exchange for the improvement in size/contour/position of  the breasts.  Some patients choose to have the breast reduction surgery earlier in life; some patients prefer to wait until they are in mature/stable relationships and/or have completed  having pregnancies.

Given that the results of surgery will be with you for a lifetime  I would suggest you save up and have the procedure done by the best  board certified plastic surgeon you can find. You may find that most well experienced board-certified plastic surgeon  are not able to participate in the Medicaid programs.

I hope this helps.

Medical insurance, including medicaid, should cover surgery that is considered medically necessary. The definition of "medically necessary" varies from contract to contract so there are considerable differences in coverage for breast reduction. From what you say, you do have symptoms that could be caused by your large breasts and, depending on the contract your state has with medicaid, it might be a covered procedure. Your best bet is to have a consultation with a board certified plastic surgeon in your area who will be most knowledgeable about coverage for your circumstances. Both the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgeons have services to help you locate a plastic surgeon in your area.Good luck to you.