Will insurance cover my breast reduction if I am 27 years old, 5'11", 240 pounds, and an H cup?

Age 27, 5'11", 240LBS, on Med, H Cup.

Doctor Answers 6

Breast Reduction and Health Insurance

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You should be a good candidate for health insurance coverage. Each company has its own guidelines and some policies have exclusions for breast reduction. The best way to find out is to have a consultation and have your Board Certified Plastic Surgeon's office apply for pre-authorization for you, they are used to the requirements and will be able to help you. If you are denied, ask the office to file an appeal for you. We have done this many times with good results! Good luck.

San Francisco Plastic Surgeon
4.8 out of 5 stars 81 reviews

Insurance Coverage for Breast Reduction

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Given your stated size the answer is , most likely.  However, each insurance plan varies now a days and nothing is guaranteed.  Check with your plan rep to go over your benefits.  The consulting plastic surgeon's office will help you too.

Breast Reduction covered by insurance

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Based on your measurements, your breast reduction surgery should be covered by insurance. However, all insurance companies set different parameters for what constitutes being medically necessary. Be sure to consult with a board certified plastic surgeon to obtain the necessary documentation as well as pictures that can be sent to the insurance company to support your need for surgery. Good Luck!

Scott Farber, MD
Boca Raton Plastic Surgeon
4.8 out of 5 stars 22 reviews

Breast reduction insurance coverage

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Based on cup size, you should be covered. Some insurance companies require documented medical management and deny for obesity. See a board certified plastic surgeon who will be able to check your insurance criteria.

Insurance and breast reduction

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It certainly sounds from your dimensions that you may be a candidate for  a breast reduction. As for insurance paying for this, I can not say because they each have different requirements for approval.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast Reduction and Insurance Coverage?

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Although it is not possible to provide you with precise advice online, based on your description, you may be a good candidate for breast reduction surgery; it may be in your best interest to drop weight first.
The best way to obtain insurance coverage for breast reduction surgery involves 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 letter/pictures from your plastic surgeon will help you obtain authorization. Make sure you're saying a well-trained/experienced board-certified plastic surgeon.  

Be prepared to be persistent when dealing with health insurance companies;  keep in mind that breast reduction surgery is one of the most patient pleasing operations we perform.

 Best wishes.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.