I'm a 31 year old mom of one in desperate need of a breast reduction. I'm a size 36K and and basically crippled by the weight of my breast. Are there any surgeons in the NYC area that accept my insurance? I have Affinity (sidebar: I've already tried Long Island Medical Group, it isn't for me)
February 17, 2019
Answer: Breast Reduction and Insurance Coverage Hi and thank you for your question. It has become commonplace for most plastic surgeons to be 'out of network' with most insurance carriers. As plastic surgeons, and physicians, we have the option of participating (or not) with the various insurance plans. Since most plastic surgeons are non-participating (or out-of-network), patients interested in applying for medically necessary breast reductions will often have to rely on their out-of-network benefits, if any. I always recommend that patients interested in a breast reduction, or any other cosmetic procedure, start their journey by scheduling an in person consultation and physical exam. Regardless of the surgeon's participation or not with your insurance plan, you would need to be evaluated to determine whether or not a case can be made to apply for medical necessity. Your surgeon would evaluate your current breast size, medical history, lifestyle, and any impairments (physical or otherwise) that have resulted from having both large and heavy breasts. As in most offices, all of my cosmetic patients meet with my cosmetic coordinator following their consultation with me who will work with the patient to explore the possibility of going through insurance. If you have not done so already, consider taking the first step and schedule a consultation with a board certified plastic surgeon who specializes in breast reduction procedures. I hope that this helps!
Helpful 1 person found this helpful
February 17, 2019
Answer: Breast Reduction and Insurance Coverage Hi and thank you for your question. It has become commonplace for most plastic surgeons to be 'out of network' with most insurance carriers. As plastic surgeons, and physicians, we have the option of participating (or not) with the various insurance plans. Since most plastic surgeons are non-participating (or out-of-network), patients interested in applying for medically necessary breast reductions will often have to rely on their out-of-network benefits, if any. I always recommend that patients interested in a breast reduction, or any other cosmetic procedure, start their journey by scheduling an in person consultation and physical exam. Regardless of the surgeon's participation or not with your insurance plan, you would need to be evaluated to determine whether or not a case can be made to apply for medical necessity. Your surgeon would evaluate your current breast size, medical history, lifestyle, and any impairments (physical or otherwise) that have resulted from having both large and heavy breasts. As in most offices, all of my cosmetic patients meet with my cosmetic coordinator following their consultation with me who will work with the patient to explore the possibility of going through insurance. If you have not done so already, consider taking the first step and schedule a consultation with a board certified plastic surgeon who specializes in breast reduction procedures. I hope that this helps!
Helpful 1 person found this helpful
