Insurance Coverage for Tuberous Breast Reconstruction?

Question

I noticed only one doctor addressed the insurance coverage for "snoopy" or "tuberous" breasts. Is it common for most insurance companies to pay for the correction? Which insurance provider would be the best choice?  Any recommendations for surgeons in Colorado that are experienced with this condition? Thank you!

Otto Joseph Placik, MD · Answer

I have had numerous cases of severe tuberous breast deformity aka constricted breasts denied by third party payors despite strong documentation and supporting letters from counselors, pediatricians, physical therapists, etc.

Jerome Edelstein, MD · Answer

Generally, insurance companies do not cover the cost of tuberous breast correction surgery. This is because tuberous breasts are more of an aesthetic concern rather than health risk. However, you should ask your insurance provider if they do.

Raffy Karamanoukian, MD, FACS · Answer

At this time, most insurance companies will deem a tuberous breast deformity a cosmetic concern and will not deny coverage.  Although it is possible for you to appeal their decision.

Scott C. Sattler, MD, FACS · Answer

I would not submit a tuberous breast procedure to an insurance company- its a cosmetic procedure with no functional benefit for the patient. Insurance companies are restrictive enough with breast operations that offer real benefit to patients (bilateral breast reduction, BRAVO study etc...) - they are going to deny any tuberous breast claim that is submitted.

	Your best option is to find a surgeon that is experiences with this difficult operation and obtain a price quote for the procedures.

Steven Wallach, MD · Answer

I do not know of an insurance company that will cover tuberous breast deformities.  It is usually deemed cosmetic.

Insurance Coverage for Tuberous Breast Reconstruction?

Answers (7)

Answer: Tuberous breasts are a cosmetic and not a functional issue

Answer: Tuberous breasts are a cosmetic and not a functional issue

Answer: Tuberour breasts and implants

Answer: Tuberour breasts and implants

Recommended reading

Everything you need to know about Tuberous Breast Correction Surgery

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

Insurance Coverage for Tuberous Breast Reconstruction?

Answers (7)

Answer: Tuberous breasts are a cosmetic and not a functional issue

Answer: Tuberous breasts are a cosmetic and not a functional issue

Answer: Tuberour breasts and implants

Answer: Tuberour breasts and implants

Browse related questions

Recommended reading

Everything you need to know about Tuberous Breast Correction Surgery

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