I am 29 with insurance and I have a consultation with a plastic surgeon in about 3 weeks to discuss a breast reduction. I am 5' 5" (1.65 m) and 215 lbs and my bra size is a 38 g/h depending on the brand. I have always had large breasts since I was a child and the neck and shoulder pain has gotten quite bad over the last few years. Do you think I would easily qualify for a breast reduction based on the size and recommendations from my doctors?
October 11, 2018
Answer: Do you think I could have 600-700 grams removed from my breasts? (Photos) None of us can predict what decisions insurance companies will make regarding coverage for BR surgery or what documentation will sway their decision. 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 most 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. The insurance companies will dictate the amount of tissue to be removed, not the PS.
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October 11, 2018
Answer: Do you think I could have 600-700 grams removed from my breasts? (Photos) None of us can predict what decisions insurance companies will make regarding coverage for BR surgery or what documentation will sway their decision. 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 most 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. The insurance companies will dictate the amount of tissue to be removed, not the PS.
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October 11, 2018
Answer: Breast Reduction and Insurance Qualification #breastreduction You will definitely benefit from a breast reduction!I don't think your plastic surgeon will have any trouble removing at least 700 grams of tissue per side. Every insurance company is different, and each policy can differ as well, so I can't say for sure if you'll qualify under your insurance plan. Additionally, some insurance companies also demand that you first undergo physical therapy or massage therapy prior to the procedure in order to qualify. Lastly, most insurance companies will only pay for the procedure if a certain amount of tissue is removed based upon a woman's height and weight. The heavier the patient, the more tissue needs to be removed. Best of luck to you!
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October 11, 2018
Answer: Breast Reduction and Insurance Qualification #breastreduction You will definitely benefit from a breast reduction!I don't think your plastic surgeon will have any trouble removing at least 700 grams of tissue per side. Every insurance company is different, and each policy can differ as well, so I can't say for sure if you'll qualify under your insurance plan. Additionally, some insurance companies also demand that you first undergo physical therapy or massage therapy prior to the procedure in order to qualify. Lastly, most insurance companies will only pay for the procedure if a certain amount of tissue is removed based upon a woman's height and weight. The heavier the patient, the more tissue needs to be removed. Best of luck to you!
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October 10, 2018
Answer: Breast reduction and insurance coverage From your photos and symptoms I would think this would qualify as a medically necessary operation, and it is likely that 600-700 grams could be removed safely. Unfortunately however that is only a doctor’s opinion and has little to do with insurance coverage. You’ll need to call your carrier yourself to find out exactly what their criteria are for coverage, and what would happen regarding coverage if you had surgery and the doctor wasn’t able to safely remove 600-700g (it’s impossible to know exactly how much can safely be removed beforehand, it can only be estimated, and removing excessive tissue during surgery just to meet an insurance company’s predetermined number could result in nipple loss).A visit to a plastic surgeon's office will help you to understand if you're a candidate for the procedure, and what aesthetic and/or functional outcomes are realistic in your particular case. In order to get a qualified, ethical, and expert opinion on your surgical options and expectations, always schedule an in-person office consultation with a plastic surgeon certified by the American Board of Plastic Surgery.
Helpful
October 10, 2018
Answer: Breast reduction and insurance coverage From your photos and symptoms I would think this would qualify as a medically necessary operation, and it is likely that 600-700 grams could be removed safely. Unfortunately however that is only a doctor’s opinion and has little to do with insurance coverage. You’ll need to call your carrier yourself to find out exactly what their criteria are for coverage, and what would happen regarding coverage if you had surgery and the doctor wasn’t able to safely remove 600-700g (it’s impossible to know exactly how much can safely be removed beforehand, it can only be estimated, and removing excessive tissue during surgery just to meet an insurance company’s predetermined number could result in nipple loss).A visit to a plastic surgeon's office will help you to understand if you're a candidate for the procedure, and what aesthetic and/or functional outcomes are realistic in your particular case. In order to get a qualified, ethical, and expert opinion on your surgical options and expectations, always schedule an in-person office consultation with a plastic surgeon certified by the American Board of Plastic Surgery.
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