Breast Reduction Co-pay for $10,000. Is it reasonable vs paying out of pocket?

This is not an uncommon scenario. Many of my patients have found that the out of pocket cost for breast reduction is very similar and sometimes even less expensive than when using insurance. Hospitals routinely need to inflate their costs for the operating room and anesthesia fees to help generate revenue. If you choose to have your breast reduction in a private OR or surgical suite, the overhead costs tend to be much less inflated. $11,000 still seems a bit expensive though. 

In general, payments from and involving insurance companies are complex, and have become more so over the past decade or so.  Each insurance policy is different and a patient needs to ascertain, carefully, what all the costs - including "covered" and "out-of-pocket" -  will be before agreeing to have surgery on an elective basis.In your case, there may be specific obligations of your policy that mandate the collection of the co-pay you're talking about.  You should discuss this with your surgeon, contact your insurance company on your own behalf to make sure that you know what all your out-of-pockets costs will be, ask if there are other surgeons who can perform the surgery with differing financial obligations on your part (some may be in a network that has a lower co-pay) and then, IF you're comfortable with those surgeons, consider switching surgeons.  Ultimately, though, you'll have to balance what you want to do (have a breast reduction) with what your costs will be, and then make a decision as to what direction to proceed in.I hope that this helps, and good luck,Dr. Alan EnglerMember of RealSelf100

I have not done breast reduction in a hospital in 15 years because of the excessive cost. Spend a bit more time looking around and comparing fees. In our area of the country this procedure should run about $10,000 including a licensed facility, board ceritified anesthesiologist and surgeon, and then insurance pays its share of that.

I do not know where you live, but my fee for a  breastreduction is $6500 + $800 for a Board Certified anesthesiologist (M.D.), and $1800 for a licensed Out patient Surgicenter.  We do not accept insurance for the reasons you mentionned.  Out of pocket expenses will be about the same as private top notch care by certified specialists.