Insurance Coverage for Breast Lifts with Severe Ptosis?

Question

I'm just curious- do insurance companies ever cover breast lifts for women with severe ptosis? For example, although my breasts don't look that big under clothes (at least in my opinion-they lack volume), they are a 32L and the nipple points down/is on the very bottom. They actually reach my waist.. I'm 23 and breastfeeding. I actually get a rash sometimes on my stomach from where my nipple touches when they leak breast milk. That's how bad they are. I don't want a lift now, just curious.

Jerome Edelstein, MD · Answer

Insurance doesn't usually cover the cost of a breast lift, however it can cover a breast reduction for which you may be suitable. You should contact your insurance provider to find out if your surgery is covered. If it is, it would have to be deemed medically necessary.

Tom J. Pousti, MD · Answer

Generally speaking, insurance companies may provide coverage for patients seeking breast reduction surgery, but not breast lifting surgery. For example, many health insurances will have specific requirements as to how much breast tissue  must be removed in order to have the procedure "covered”.

If you are considering breast surgery, it would be in your best interests to  wait at least 3 to 6 months after you have stopped breast-feeding before proceeding.

Best wishes.

Ronald J. Edelson, MD · Answer

Most insurance companies cover the cost of breast reduction but not a breast lift, no matter what kind of problems they cause for you.  Sometimes they will consider an issue such as skin rash, so you can always ask them.  But your chances of having it covered are small.  Sorry.

Naveen Setty, MD · Answer

I have never seen an insurance company cover a breast lift, but that does not mean it is impossible.  The best thing you can do is see a board-certified plastic surgeon and have him or her submit your case to the insurance company.  Good luck!

Edwin C. Pound, III, MD · Answer

You could certainly try, but I have never seen insurance cover a breast lift in my career.  Although breast lifts and breast reductions are essentially the same operation (the difference being that breast tissue is removed during a breast reduction), insurance companies see a breast reduction as a functional problem and a breast lift as a cosmetic problem.  They will only cover functional problems.  If you can somehow convince them that this is indeed a functional issue then you might have a chance but I would be very surprised if they covered it.

Insurance Coverage for Breast Lifts with Severe Ptosis?

Answers (10)

Answer: Insurance coverage for breast lift

Answer: Insurance coverage for breast lift

Answer: Breast lift coverage with insurance

Answer: Breast lift coverage with insurance

Recommended reading

Everything you need to know about Breast Lift

Our mission is to create a world where every investment in modern beauty is Worth It.

Insurance Coverage for Breast Lifts with Severe Ptosis?

Answers (10)

Answer: Insurance coverage for breast lift

Answer: Insurance coverage for breast lift

Answer: Breast lift coverage with insurance

Answer: Breast lift coverage with insurance

Browse related questions

Recommended reading

Everything you need to know about Breast Lift

Our mission is to create a world where every investment in modern beauty is Worth It.