Will Cigna insurance cover a breast reduction from a D cup to a B cup?

Hello, thank you for your question. None of us can predict what decisions MEDICAL insurance companies will make regarding coverage for BR surgery or what documentation will sway their decision. BRs which are medically necessary (i.e. you suffer back, shoulder, and neck "pain" with DOCUMENTED medical attention over a period of a YEAR) are typically covered by medical insurance. If not, your medical insurance may try to deny you based upon a lot of things such as weight, lack of symptoms, lack of previous medical management, and lack of enough tissue that should be removed. Determine what medical information is required for your medical insurance carrier to issue a pre-authorization or predetermination of benefits for BR surgery. Then seek consultation with a board certified plastic surgeon who can evaluate your medical condition, discuss the pros and cons of this surgery as it applies to you, determine the amount of tissue to be removed, and help you in completing the paperwork required by your medical insurance company.

Hello and thank you for your question.
I suggest contacting your Insurance company to see if breast reduction surgery is a covered benefit. Schedule an appointment with a board certified plastic surgeon to be evaluated and to discuss your options. Best of luck!

Coverage for breast reduction typically is based on a certain amount of breast tissue to be removed. It varies from different insurance companies. Calling your insurance company followed by consultation with a plastic surgeon will give you the information to at least get started.

Dear Thoughtful386412,
in some cases, breast reduction is covered by insurance. Breast reduction is best suited for women who wish to decrease the size of their breasts. While there are different techniques used to perform this surgery, I prefer the vertical incision (lollipop pattern) breast reduction technique instead of the anchor scar pattern, which reduces more noticeable scarring than usual. I also use a SAFE liposuction technique to reduce additional fat around the stubborn axilla area and bra line. This way, my patients are achieving beautiful results with minimal incisions which reduces downtime and delivers an overall better breast shape long term.If you are considering breast reduction surgery, you should consult with a board certified plastic surgeon to discuss your options and make sure your surgeon understands your goals. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Each plan is unique in what is covered and what criteria must be met for coverage to be provided. Visit with a board certified plastic surgeon for an examination and consultation. A letter that includes the findings from your examination can be submitted to your insurance company for approval of the reduction.

Find a plastic surgeon that takes your insurance carrier.

After a consultation, your PS will send a predetermination letter to see if you qualify for a breast reduction based on the criteria outlined by your specific insurance.

If you are approved, the insurance will require a certain number of grams per side to be removed in order for them to approve your surgery.

Discuss with your PS how many cups you will likely be reduced based on the number or grams required.

Best of luck

Jack Peterson MD

Insurance coverage for a breast reduction depends on a few factors. You have mentioned a few, such as back pain, breast pain, etc. The process starts by going to be a consultation with a plastic surgeon, and they can then submit your case to insurance for a pre-authorization. The other component to consider is that insurance will calculate a certain amount that needs to be removed for it to be "medically necessary." (Google Schnur Scale). The surgeon should be able to give you an idea if this amount will work with your desired final cup size. Hope this helps. Dr. W

Every insurance plan is different and specific coverage will depend on your plan's benefits. Every patient is screened in my practice so that a predetermination letter can be submitted with photos so that benefits and financial responsibilities can be clarified. It sounds like your surgery should be covered but we will only know after the predetermination process.