Will insurance cover me if my breast causes pain?

Hi Tiffani84, 
I understand your concern.In some cases, breast reduction is deemed medically necessary and covered by some medical insurance provider provided that your breasts size has caused significant symptoms like pain. It would be best, however, to speak with your medical insurance provider and check your insurance policy to determine which procedures are covered. 
Daniel Barrett, MD, MHA, MS

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgery

Member, American Society of Aesthetic Plastic Surgery

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 providers.  If not, they may try to deny you based upon a lot of things such as lack of symptoms, lack of previous medical management, and lack of enough tissue that should be removed. Read your medical insurance certificate of coverage. Determine what medical information is required for your insurance 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.  Kenneth Hughes, MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA

Insurance will cover breast reduction. However, one must make a case for medical necessity. In the case of symptomatic macromastia/heavy breasts, patients will often complain of intertriginous rashes, back, neck and shoulder pain as well as bra strap grooving. These symptoms have often been resistant to medical therapy, weight loss, and physical therapy.As always, discuss your concerns with your board certified plastic surgeon (ABPS).

The answer is that this depends on your insurance policy. Some policies do not cover breast reductions at all, and some do but with certain parameters. This may be based on your weight and height, the amount of breast tissue you need reduced, and sometimes they even require photos and documentation from your plastic surgeon to be authorized. I suggest calling your insurance company to find out if this surgery is covered by your policy. If not, I suggest seeing a BC plastic surgeon to see what the costs of the surgery would be. 

Insurance companies have criteria for what qualifies for them to cover/pay for a breast reduction.  Depending on the insurance company, a certain amount of breast tissue must be removed for it to qualify... this is frequently 500 grams of breast tissue but can vary a good bit.  Be sure you request to see comparable before an after pictures of patients similar to you at the time of your consultation so that you and your surgeon are on the same page.

Hi and welcome to our forum!
You appear to demonstrate many of the cardinal symptoms of patients requiring breast reduction which includes: neck and shoulder pain, bra strap grooving, rashes under the breasts, repeated infections beneath the breasts, and limitation in activity resulting from breast size. None of these symptoms will be addressed by a breast lift, as the procedure only removes redundant skin, and does not appreciably affect breast size.
If you satisfied with your breast size and if the symptoms are insignificant, you may consider a breast lift. It will most likely NOT be covered by any insurance plan.
On the other hand, if your symptoms are significant, consider breast reduction, which likely WOULD be insurance covered.
I recommend a consultation with a board certified plastic surgeon.
Best wishes...

A Breast Lift is not usually paid for by insurance, the procedure is considered cosmetic and not medically necessary. During your consultation with your surgeon, he or she will be able to access your breast size and physical complaints.