Will Insurance Cover Breast And/or Tummy Reduction if There Are Problems?

I am 5`6" and ever since I hit menopause I grew this stomach and my breast are wearing a 38DDD reduction bra. Between the two my back and shoulders ache so badly followed by headaches. Is anything like a breast reduction and tummy tuck covered under insurance?

Doctor Answers 3

Insurance Coverage for Breast Reduction and Tummy Tuck

If you meet your insurance companies guidelines for breast reduction you will most likely get coverage. Most require that you need to have 500 grams of breast tissue removed from each breast, this equates to about a DD cup size. Tummy tucks are not a covered procedure in most cases, but if you are having symptoms and pain you can always try. See a Board Certified Plastic Surgeon that specializes in breast reduction to help you determine your options and submit for insurance coverage. Good luck!

San Francisco Plastic Surgeon
4.8 out of 5 stars 75 reviews

Insurance coverage for breast reduction and tummy tuck

Unfortunately, insurance does not cover tummy tucks.  Breast reduction may be covered; the first step is to examine your insurance company criteria, which are likely to be available online.  Many carriers will precertify the procedure but require documented conservative management, including chiropractic or physical therapy for 3-6 months.  See a board certified plastic surgeon who performs breast reductions regularly and will be knowledgeable about navigating the insurance jungle!

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 40 reviews

Breast reduction is often covered by insurance.

A separate solicitation needs to be made to your carrier to know for certain. They have different sets of criteria. The likelihood of coverage for an abdominoplasty is remote.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

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.