Hello , I am a 47 year old African American woman. 6'0 ft. tall ..240 pounds and I have very long sagging breasts that's causing pains throughout my upper body ..like my neck my back and my chest..My breast are a size 44 DDD, I have had a few consultations with the surgeon saying I am a perfect candidate for the procedure,the problem is insurance won't cover it saying that for medical purposes they'd need to remove more tissue than the surgeon recommended.what do I do now?
Answer: Consult with a plastic surgeon who specializes in mastopexy/ reduction. This is very common, in fact, in many areas, it is hard to find plastic surgeons who take insurance even for approved breast reductions. Most plastic surgeons offer mastopexy or reduction as an out-of-pocket expense. So shop around a bit for someone offering reasonable price and perhaps offering financing options. Even patients with mostly ptosis- rather than macromastia will have significant improvement in symptoms with lifting and small reduction. Insurance companies usually make it very difficult to get coverage.
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Answer: Consult with a plastic surgeon who specializes in mastopexy/ reduction. This is very common, in fact, in many areas, it is hard to find plastic surgeons who take insurance even for approved breast reductions. Most plastic surgeons offer mastopexy or reduction as an out-of-pocket expense. So shop around a bit for someone offering reasonable price and perhaps offering financing options. Even patients with mostly ptosis- rather than macromastia will have significant improvement in symptoms with lifting and small reduction. Insurance companies usually make it very difficult to get coverage.
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October 25, 2023
Answer: Options if insurance will not cover the surgery If your insurance will mot cover the procedure there are three possible options for you. First is paying for the procedure out of pocket as a cosmetic operation. That may not be a possibility, but is always an option. The second is to find out how your insurance determines eligibility. A lot of the time weight is considered, and the more someone weighs the more they require to be removed. You could ask them what you would need to weigh in order to qualify based on the estimate that was made by your surgeon and work toward that as a weight loss goal. The third option, which may not be a reasonable option, is to consider a different insurance provider, and select one with a more generous benefit regarding breast reduction surgery.
Helpful
October 25, 2023
Answer: Options if insurance will not cover the surgery If your insurance will mot cover the procedure there are three possible options for you. First is paying for the procedure out of pocket as a cosmetic operation. That may not be a possibility, but is always an option. The second is to find out how your insurance determines eligibility. A lot of the time weight is considered, and the more someone weighs the more they require to be removed. You could ask them what you would need to weigh in order to qualify based on the estimate that was made by your surgeon and work toward that as a weight loss goal. The third option, which may not be a reasonable option, is to consider a different insurance provider, and select one with a more generous benefit regarding breast reduction surgery.
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October 5, 2023
Answer: Breast Reduction Hello and thank you for your question. You can try appealing the insurance company decision. If you are still denied, you can have the breast reduction as a self pay patient. Reach out to your surgeon with your concerns. Best wishes!
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October 5, 2023
Answer: Breast Reduction Hello and thank you for your question. You can try appealing the insurance company decision. If you are still denied, you can have the breast reduction as a self pay patient. Reach out to your surgeon with your concerns. Best wishes!
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September 25, 2023
Answer: Breast reduction If your insurance is denying your breast reduction but you still would like to have the procedure you can consider paying for it out of pocket. There are financing companies who specialize in credit for medical procedures. Some examples include CareCredit, PatientFi, and Alphaeon Credit. See your board certified plastic surgeon to find out more.
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September 25, 2023
Answer: Breast reduction If your insurance is denying your breast reduction but you still would like to have the procedure you can consider paying for it out of pocket. There are financing companies who specialize in credit for medical procedures. Some examples include CareCredit, PatientFi, and Alphaeon Credit. See your board certified plastic surgeon to find out more.
Helpful
September 25, 2023
Answer: Breast reduction Unfortunately this is a pretty common occurance, fighting with insurance companies. You can appeal with the insurance company and annoy them mercilessly. You’d be surprised how the squeaky wheel gets the grease. Otherwise you can pay out of pocket and have it done in a plastic surgeons office to keep costs down. In our office surgicenter it would be no more than $15,000
Helpful
September 25, 2023
Answer: Breast reduction Unfortunately this is a pretty common occurance, fighting with insurance companies. You can appeal with the insurance company and annoy them mercilessly. You’d be surprised how the squeaky wheel gets the grease. Otherwise you can pay out of pocket and have it done in a plastic surgeons office to keep costs down. In our office surgicenter it would be no more than $15,000
Helpful