I’m 5’4, about 150 lbs, and have B/C cup. I have stretch marks, they hurt when I go down stairs, can’t run without it hurting. The sides hurt wearing a bra and after sleeping. They don’t feel apart of me and always hated them. They make me stay in my room/don’t go out cause my body is disproportional. They make me depressed/anxious I can’t help but cry when I look in the mirror. Would I need mental diagnosis for them to cover? Would they even consider paying for it when my breasts aren’t large?
Answer: Insurance Coverage for Breast Reduction Hi and thank you for your question. The best first step would be to contact your insurance carrier and inquire as to what their specific criteria is for medical necessity coverage for a breast reduction and to see whether or not you have out of network benefits. Most insurance carriers have a preset criteria list that must be met to obtain medical necessity coverage, and this list often includes but is not limited to: Amount/weight of breast tissue to be removedDocumented back, neck and shoulder painDocumentation of failed conservative management and therapy (i.e. chiropractic, physical therapy, orthopedic, dermatological)Once you have contacted your insurance company, you should then contact a local Board Certified Plastic Surgeon to schedule a consultation to determine your candidacy for a breast reduction. Your Plastic Surgeon's office would then submit all the necessary documentation to your insurance carrier in the hopes of obtaining medical necessity coverage and if denied they should also attempt an appeal on your behalf.I hope that this helps!
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Answer: Insurance Coverage for Breast Reduction Hi and thank you for your question. The best first step would be to contact your insurance carrier and inquire as to what their specific criteria is for medical necessity coverage for a breast reduction and to see whether or not you have out of network benefits. Most insurance carriers have a preset criteria list that must be met to obtain medical necessity coverage, and this list often includes but is not limited to: Amount/weight of breast tissue to be removedDocumented back, neck and shoulder painDocumentation of failed conservative management and therapy (i.e. chiropractic, physical therapy, orthopedic, dermatological)Once you have contacted your insurance company, you should then contact a local Board Certified Plastic Surgeon to schedule a consultation to determine your candidacy for a breast reduction. Your Plastic Surgeon's office would then submit all the necessary documentation to your insurance carrier in the hopes of obtaining medical necessity coverage and if denied they should also attempt an appeal on your behalf.I hope that this helps!
Helpful