Size 40DD Having Issues With Fungus/Yeast Infection - Breast Reduction Needed?

Question

I have infections under my breast often. Would my insurance cover this issue ?

Nia Banks, MD, PhD · Answer

Recurrent rashes under the breasts may qualify your breast reduction for insurance coverage. It is best if you have documentation of seeking medical care for these rashes, such as a doctor's note or a record of prescription medications for the rashes. The strongest criteria for insurance coverage of a breast reduction is a documented history of back pain not responding to other treatments and an operative plan to remove a significant weight of breast tissue per breast (google 'Schnur scale').

Jeffrey Weinzweig, MD, FACS · Answer

If you have reaccuring infections due to your breast size you would be a good canidate for a reduction. Each insurance company is different, but they should cover this procedure. The more documentation you have the better. You should consult with a board certified plastic surgeon and they can write a letter to send to your insurance

Tom J. Pousti, MD · Answer

Thank you for the question.

	Based on your description you may be a good candidate for breast reduction surgery for physical relief and control of infections.

	The best way to obtain insurance coverage for breast reduction surgery involves some &ldquo;hoops&rdquo; 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 &ldquo;authorization&rdquo; for the procedure.

	This documentation and letter/pictures from your plastic surgeon will help you obtain authorization. Make sure you're  working with a well-trained/experienced board-certified plastic surgeon.
	 

	I hope this helps.

S. Daniel Golshani, MD, FACS · Answer

Simply said, size 40DD and yeast infections under breasts are an indication for breast reduction surgery based on a functional need basis and should be covered by your insurance company. Variables which could prevent coverage are a high Body Mass Index (BMI) and a need for weight loss and lack of any history of previous conservative medical management. Also, coverage varies based on type of insurance coverage. It is best to consult with your family physician for documentation and basic attempts to relieve your symptoms. When visiting a board certified plastic surgeon, photographs should be taken and submitted to your insurance company if indicated or required.

Darryl J. Blinski, MD · Answer

There are a list of insurance criteria for approved breast reduction. Call your insurance company to see if you fit their criteria. I believe you do. Or see a boarded PS in your area to send a predetermination letter to your insurance company with a photo of your breasts. After receiving an approval letter then have the operation. Best from MIAMI

Mark Preston, MD · Answer

The most common complaints that I hear from patients desiring breast reduction are:

	
		Chronic neck, back and shoulder pain
	
		Poor posture
	
		Bra strap grooving
	
		chronic intertrigo under the breasts


	Insurance coverage varies from patient to patient. Some companies require evidence of failed conservative therapy, some require a specific amount of tissue removal based on a patients BMI, some don't cover the procedure at all. A letter from your surgeon to the your insurance company should give you the information you need.

Peter E. Johnson, MD · Answer

Recurrent rash and infection under the breast, also called intertrigo, is a very worthy consideration for breast reduction. We feel coverage should be available and breast reduction will help. However insurance policies can be very specific when it comes to criteria for breast reduction, and some will exclude the benefit altogether. Consultation with a plastic surgeon within your health plan, and a predetermination of benefits will sort things out.
	Best of luck,
	peterejohnsonmd

Stephen Delia, MD · Answer

Many patients have good symptomatic relief of back pain, shoulder pain and rashes under the breast after reduction mammoplasty. Insurance companies differ in their criteria for coverage but usually require a minimal amount of tissue to be removed and may also require documentation of symptoms by your doctor. Consult a board-certified plastic surgeon experienced in breast reduction surgery.

Steven Wallach, MD · Answer

I fyou have very alrge breasts and are having problems with rashed, then you may be a candidate for a breast reduction. As for coverage by insurance, you should really ask your insurance company what their criteria are for coverage.

Edward J. Domanskis, MD (in memoriam) · Answer

If you have medical, dermatological problems with your breasts, then your insurance should cover your surgery which will hopefully correct this problems. We usually try and get pre-autrhorization for our patients by taking photos and writing a letter on our patients behalf for each insurance plan is different. Watch my video.

Size 40DD Having Issues With Fungus/Yeast Infection - Breast Reduction Needed?

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