Getting a breast reduction covered when I have a contract exclusion. Any suggestions?

Breast reduction in the Chicago area can be quite difficult with some plans and insurance appeal can help, however under affordable care there are policies with an exclusion for breast reduction. This means your policy does not cover the procedure, ever. With open enrollment you can consider a switch, and we find the HMO plans easily worked through, and if you cannot change, reduction can be made affordable as an office procedure.

Depending
on your particular health insurance plan, breast reduction surgery may be
considered a covered benefit. Some insurance carries may cover your breast
reduction surgery based on the size of your breast, your body habitus, and the
severity of back, neck, and shoulder pain caused by your large breast. Breast
reduction surgery is generally considered a reconstructive procedure and may be
covered by health insurance when it is performed to relieve these medical
symptoms. Many insurers determine whether to categorize breast reduction
surgery as reconstructive surgery based on the amount of tissue that will be
removed. Breast reductions involving removal of small amounts of tissue may not
be covered by your insurance. Similarly, some insurance plans have exclusionary clauses that do not cover breast reduction. Insurance policies vary greatly and even when pre-certification is successful it is not a
guarantee of payment. It sounds like your only option at this point is to pay out of pocket or switch insurance plans.