How to get GHI city of NY employee insurance to pay for breast reduction? (Photo)

Question

I am 24 5'4 and 216 lbs I know I am over weight but I am on a diet and went for 240 to the 216. I have am a 40DD maybe larger because I can't find the right bra my breast don't slip under from. I had MRI in 2014 of back and neck due to bad pain it showed I have herniated bulging disks in my neck down my spine a pinched nerve InMy neck that could be related to the size weight of my Breast the right breast is larger than the left. If it can be approved. Y the insurance it is something I want done.

Vinod V. Pathy, MD, FACS · Answer

Thank you for your question.  It certainly sounds and looks like you might be a candidate for breast reduction surgery.  Please contact your insurance directly to find out what supporting documentation needs to be submitted.  Every insurance company is different but most require you jump through multiple hoops prior to approval for a reduction.  Best of luck.

Steven Wallach, MD · Answer

Sounds reasonable that you are a candidate for a Breast reduction. You can always check first with your insurance company about their criteria and then go for a consultation with a surgeon. Good luck.

Robert L. Kraft, MD, FACS · Answer

You need to start the preauthorization process by seeing a board certified plastic surgeon and going through the required items.  A preauthorization letter alone does not cut it anymore with GHI.  There is a laundry list of criteria and the letter goes out only when all the information is on file.  Keep in mind that the treatment for a herniated disc is spinal surgery, not a breast reduction.  The asymmetry is not covered as standalone diagnosis but both breasts appear to meet the gram weight standard.

How to get GHI city of NY employee insurance to pay for breast reduction? (Photo)

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How to get GHI city of NY employee insurance to pay for breast reduction? (Photo)

Answers (3)

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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.