How do I get United Healthcare to cover a breast reduction surgery? (photos)

Insurance can be very confusing! Different policies may have different requirements, your best bet is to find a Board Certified Plastic Surgeon that you feel comfortable with and have your surgeon apply for you. If it is a covered procedure under your policy, you should qualify. If by chance they deny benefits, ask your surgeon to appeal your case, I have gotten several patients approved this way. Good luck!

I am sorry to hear about the problems you are experiencing secondary to breast hypertrophy; based on your description you may be an excellent candidate for breast reduction surgery at some point. It will be in your best interests, for several reasons, to achieve a lower/stable long-term weight prior to proceeding. “Official” recommendations of course would necessitate in-person consultation.
Breast reduction surgery is one of the most patient pleasing operations we perform. By removing “excess” breast tissue, adipose tissue, and breast skin this operation reduces AND lifts the breasts to a higher position on the chest wall (in other words, the breasts are "automatically" lifted when a breast reduction is performed). By doing so, patients often find improvement in neck, back, and shoulder discomfort and find it easier to form their activities of daily living and exercise.
Obtaining insurance coverage for breast reduction surgery will likely involve some “hoops” to jump through. 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 letters/pictures from your plastic surgeon will help you obtain authorization. Prepare to be persistent when dealing with health insurance companies.
When the time is right, seek consultation with well-trained/experienced board-certified plastic surgeons. Ask to see lots of examples of their work and communicate your goals clearly.
I hope this, and the attached link, helps. Best wishes as you work towards your goals.

Every insurance plan has their own unique criteria on whether they will
cover a breast reduction. More and more, we are seeing plans where a
breast reduction is not a covered benefit. If it is a covered benefit,
some insurance plans set a minimum required amount of tissue to be
remove in order to met their threshold for coverage. Some set the amount
in relation to your BMI (height and weight). Others require extensive
medical records documenting neck pain, back pain, and history of rashes.
The other alternative is to opt for a breast reduction as a self-pay
option. Start by visiting with a board certified plastic surgeon to
learn more about your options.Best wishes,Dr. BasuHouston, TX