Where do I start with the breast reduction process, as far as getting it covered by insurance? (Medcost)

Question

Since high school I've always wanted a breast reduction. I was a 34 DD, sports all year round, 5'2" 120 lbs. Now being a mom of a 1 and a half year old I am a 38 DD (barely fit) & 40 lbs heavier. (I've been a 38 DD since I got pregnant and even stopping breast feeding they have gone no where) Can't get through folding/hanging a load of landry, washing a load of dishes, and sometimes just changing a diaper or putting my son in his carseat has my back in so much pain, even straightening my back.

Gary M. Horndeski, MD · Answer

Thank you for you question,         The Bellesoma Method is a current technique to lift and/or reduce breasts without using implants or the ugly vertical scars.  The incisions are hidden around the areola and in the inframammary crease. The vertical incision has been completely eliminated. The areola incision heals almost invisibly due to the fact that there is hardly any tension on the closure. With this particular technique, ducts are preserved along with nerve supply maintaining nipple sensation and the ability to breast feed. Because the breast is reshaped internally and is secured to your chest muscles, upper pole fullness is possible without an implant. Attached is a patient who underwent The Bellesoma Method. Please note that her tissue was used to create upper pole fullness and cleavage without any foreign materials (mesh, implants, etc).  Unfortunately, we do not accept insurance for breast reductions.  Dr. Horndeski does not remove enough breast tissue to meet insurance criteria.  Instead, he utilizes the breast tissue to reshape the breast.  It is a proprietary technique that only surgeons that have been trained by me can perform. I hope this helps. Best wishes and kind regards, Dr. Gary Horndeski

Ellen A. Janetzke, MD · Answer

Hello! your. best bet is to contact your insurance company and speak to someone in member benefits. They will be able to assist you in determining what is required for coverage. Once that is determined, schedule consults with board certified plastic surgeons to learn about the procedure! Good luck!

Tom J. Pousti, MD · Answer

Thank you for the question and congratulations on your decision to proceed with breast reduction surgery; this operation tends to be one of the most patient pleasing operations we perform. Based on your description, it sounds like you may be an excellent candidate for the procedure.  
Best to check directly with your insurance company to see whether breast reduction surgery is a “covered” benefit with your specific policy. Then, given that every insurance company has different “criteria”, best to identify exactly what your specific insurance company considers criteria for approval. Generally, the more documentation you have (for example, from your primary care doctor, physical therapist, chiropractor etc.) the better when it comes to obtaining insurance “authorization” for the procedure.  
This documentation and letter/pictures from your plastic surgeon will help you obtain authorization. Keep in mind, as you work towards your goals breast reduction surgery is one of the most patient pleasing operations we perform. 
Also, prepare to be persistent when dealing with health insurance companies.  Best wishes.

Jack Peterson, MD · Answer

Check with your insurance carrier to determine if 1) policy covers breast reductions (many policies now write breast reductions completely out of coverage) and 2) if they do cover,  what they require in terms of documentation (back aches, shoulder pain, headaches, etc) before they will approve a surgery.A board certified plastic surgeon in your area should be familiar with the process of submitting a pre-determination of benefits..

Erica Anderson, MD · Answer

I recommend you contact your insurance carrier to see what benefits you have and how to proceed. There are likely in network physicians that they can refer you to. Best wishes.

Where do I start with the breast reduction process, as far as getting it covered by insurance? (Medcost)

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Answer: #breastreduction #insurance

Answer: #breastreduction #insurance

Answer: Insurance Breast Reduction

Answer: Insurance Breast Reduction

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Everything you need to know about Breast Reduction

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Where do I start with the breast reduction process, as far as getting it covered by insurance? (Medcost)

Answers (8)

Answer: #breastreduction #insurance

Answer: #breastreduction #insurance

Answer: Insurance Breast Reduction

Answer: Insurance Breast Reduction

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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.