Will my insurance, BCBS of Texas cover breast reduction surgery? (Photo)

Question

I have upper/lower back pain, neck pain and shoulder pain due to my extremely large breasts. My bra size is a 38 FF or 38 G. Recently there has been an increase in pain in these areas. I have divots on both shoulders from brastraps. Breathing is difficult and pressure on rib cage. Surgery to remove 2 large lumps from my armpits. It was breast tissue. I am 5'7 and 170lbs. I practice yoga 3-4 times a week. I have stretched and strengthened my body through yoga. The pain and discomfort continues.

Michael A. Epstein, MD, FACS · Answer

Thank you for your question, it is a common one.Every insurance company is different.  You do seem like you would qualify, but again, there may be something in your policy where you wouldn't be covered (some companies require proof of physical therapy that didn't help the discomfort).   I recommend starting by looking up your insurance benefits (or calling your insurance company to ask).  If it is a covered benefit, then I would find a plastic surgeon in your network who will evaluate you and guide you through the rest of the process.Best of luck!-Dr. Michael Epstein

Terence Michael Myckatyn, MD · Answer

There is a good chance that insurance will cover your breast reduction. You will need the following things to improve the chances :1) supportive letter from your primary care physician or gynecologist or other physician to document that you have had trouble because of your large breasts and would benefit from reduction2) documented attempts at weight loss, 3) physical therapy, exercise, etc to control your discomfortThe decision will come down to the amount of breast tissue to be removed versus your height and weight. People with very large symptomatic breasts who have a body mass index (BMI) under 30 are typically covered, with a BMI greater than that, it becomes less likely but not impossible.

Lawrence Bundrick, MD (retired) · Answer

Most insurances, including BCBS are good about approving breast reductions as long as they meet certain criteria. You would need to find a surgeon that accepts BCBS and from there, their office would send in the request for approval. Usually pictures are required for BCBS. If and when approved, know that you would still be responsible for meeting your deductible first before your insurance would pay out. Good Luck

Will my insurance, BCBS of Texas cover breast reduction surgery? (Photo)

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Will my insurance, BCBS of Texas cover breast reduction surgery? (Photo)

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Everything you need to know about Breast Reduction

Our mission is to create a world where every investment in modern beauty is Worth It.