I Have Rashes Under my Breasts Due to Sagging. Can I Get Insurance for a Lift? (photo)

I am 22 (young), no children, breastfeeding, and I'm not obese. Yet my breasts are fairly large(34DD), sag low on my chest, and nipples go downwards. This causes bad rashes under my breasts due to skin on skin contact and I don't want to have to use creams to treat it my whole life. Can insurance cover a breast lift if the reasoning is to prevent these rashes?

Doctor Answers 12

Insurance doesn't usually cover breast lifts

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Insurance doesn't usually cover the cost of a breast lift, however it can cover breast reduction. You should contact your insurance provider to find out if your surgery would be covered. If it is, it would have to be deemed medically necessary.

Can I Get Insurance for a Lift?

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Most insurers will only cover a lift when they have to by statute, and that requirement is limited to matching a reconstructed breast after breast cancer treatment.

Mastopexy is usually considered cosmetic by almost all carriers, even if there may be a medical indication present. 

Often breast reductions are covered, and a lift is an integral part of a reduction operation. However, you don't mention that as a goal. Most carriers use a height and weight table to determine how much breast tissue needs to be removed to be covered. My hunch is that the requirement might leave you with far less breast tissue than would be desirable.But you can only find out in the setting of a consultation.

Thanks for your question, and for the posted photo. Best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Breast Lift or Reduction

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    A breast lift will not be covered by insurance, but a reduction may be covered if you meet certain requirements.  This may reduce your breasts to a size that is not large enough for you. 

Rashes under the breasts, Intertrigio, is a medical condition associated with large breasts

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A breast lift is a purely cosmetic procedure and will never be covered under most insurance plans; however a breast reduction will usually be covered under the same circumstances.   If you are a 34DD, depending upon your weight and height then you may be a candidate for a breast reduction.   Rashes under the breast, also known as intertrigio, is a medical condition associated with large sagging breasts.  It usually gets worse in the summer time.  I would also be good for you to be seen by your family physician to document this condition and possibly prescribe treatment.   It medical treatment fails then you are more likely to get approval.  

Does insurance pay for lift?

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It depends on your policy.  Often times insurance will pay for a breast reduction, which includes a lift, as long as certain criteria are met.  You can talk with your carrier to see what their requirements are.  A Board Certified Plastic Surgeon can also help you in the process by beginning a predetermination letter as well as educating you about the surgery.  Good luck!

Mennen T. Gallas, MD
Katy Plastic Surgeon

I Have Rashes Under my Breasts Due to Sagging. Can I Get Insurance for a Lift?

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It depends upon the restrictions of the exact health plan you have and signed into. But breast lifts are not covered only reductions of 500 grams per side, which in your case would leave you an A or B cup. 

Insurance coverage for breast surgery

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Thanks for your question and picture.  Unfortunately, almost all insurance companies consider a breast lift a cosmetic procedure only despite medical problems such as rashes.  However, a breast reduction surgery is sometimes covered by insurance.  In a breast reduction, the breast is reduced in size but also lifted.  A consult with a board-certified plastic surgeon will give you the best information.  Good luck!

Insurance and breast sagging and rashes

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Usually insurance companies will not cover a breast lift even with rashes.  Sorry but you will more than likely have to pay for it yourself if you want them lifted.

Insurance does not cover breast lifts

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Rashes under the breasts, called intertrigo, are not a basis for coverage of a breast lift. If you are concerned about the rashes, then you should see a board certified dermatologist for management. Insurance companies do not consider a lift justified based upon rashes. You can view your insurance company guidelines on the internet. Breast reduction to alleviate musculoskeletal complaints is frequently covered subject to minimum gram weight requirements and documented conservative medical management.

“Sagging” Breasts, Rashes, and Insurance Company Coverage?

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Thank you for the question and pictures.

Despite your symptoms, it is extremely unlikely that health insurance companies will cover breast lifting surgery. On the other hand, breast reduction surgery may be a covered benefit.  Insurance companies that do cover this procedure will have requirements as to how much breast tissue must be removed.

 At some point, you may benefit from in-person consultation with board-certified plastic surgeons to discuss your goals as well as treatment options.

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.