3 years ago had gastric sleeve done; have lost 146lbs. Any surgeon that's willing to take BCBS for the breast lift/aug? (Photo)

Do anyone know of a surgeon that is willing to take BCBS for the breast lift/augmentation? $8500 cash is a lot for a single parent to come up with. Any advice will be greatly appreciated! I recently spoke with my insurance company about the breast augmentation (I got the CPT codes) and it's all covered by my insurance.

Doctor Answers 3

Aug/Lift Cost

Your insurance company will often say that a procedure is covered if medically necessary. In your case, they will never say that you meet the medical necessity criteria. An example of a patient that meets criteria for aug/pexy: mastectomy and breast reconstruction on one side and needs aug/lift on the natural side to match the reconstruction. If the cost of cosmetic surgery is too much, I would recommend looking into educational programs. In these training programs, senior residents or fellows (finished residency) take on their own patients for cosmetic surgery. The surgery is performed under the supervision of an experienced plastic surgeon. The cost for these procedures are typically more than 50% off community standard pricing. Attached is an example. Best of luck!

3 years ago had gastric sleeve done; have lost 146lbs. Any surgeon that's willing to take BCBS for the breast lift/aug?

It is extremely rare for insurance to cover breast surgery even after weight loss as you have had.  Most plastic surgeons that accept insurance will see you and can submit your case to the insurance company to ensure that it is a truly covered procedure prior to any surgery.  Good luck!

Naveen Setty, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 62 reviews

3 years ago had gastric sleeve done; have lost 146lbs. Any surgeon that's willing to take BCBS for the breast lift/aug?

Unfortunately it is fairly common for an insurance contact to tell you a procedure like this is covered, but once the doctor contacts them you will find out otherwise, this would only be covered if you had been treated for breast cancer. In any other case they will ultimately deny your claim as breast lift and augmentation is purely a cosmetic procedure. But I do wish you good luck in this. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

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