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

Question

I am 22 5'1 110-113 lbs. I am a 36 D. My back neck and shoulders hurt and I've been experiencing chest pain. The chest pain is like a soreness in my breast, when I exercise my breast hurt. They're heavy and I'm noticing that my posture is becoming hunched over and my breast sag bad. Since I am a very small person i want to go as small as possible. With my height, weight and the pain I have been experiencing do you think cigna will cover some or all of my medical expenses or none at all?

Kenneth Hughes, MD · Answer

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.

Scott C. Lindsay, DO · Answer

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!

Camille Cash, MD · Answer

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.

Ronald J. Edelson, MD · Answer

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.

Daniel Barrett, MD · Answer

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

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

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

Answers (8)

Answer: Breast reduction

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Everything you need to know about Breast Reduction

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