From experience, how difficult is it to get insurance to cover the cost of the surgery?

Question

I’m 5’8, 125-130, small frame and a 34DD. I have loose shoulder joints, arthritis in the shoulders, upper back/neck pain and skin irritation just to name a few of my issues. I go to the chiro weekly for adjustments, always focused on upper back/shoulders. Ive been to PT and seen an orthopedic for shoulder problems. My Gyn is also aware of my complaints and problems. I just want to sure I am fully prepared. Do insurance companies have a breast to body ratio?

Kimberly Singh, MD · Answer

Based on your height or weight 530 grams would need to be removed from each breast. You would have to contact your insurance company to see what their requirements are for the grams to be removed. They may require more grams to be removed. Depending on how large your breasts are your physician may believe that more than 530 grams is too much tissue to be removed based on your size and frame, which could be the determining factor of whether or not you can get your insurance to cover it. If they request more than 530 grams then your physician may suggest doing a cosmetic breast reduction. There are a lot of determining factors that you will have to discuss with your physician.

From experience, how difficult is it to get insurance to cover the cost of the surgery?

Answers (1)