36 year old woman, 5'5, 153lbs and a 36DDD or G size bra. (Photo)

The breasts can be reduced again, and this is not that uncommon.  None of us can predict the decisions an insurance company 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 medical insurance. If not, United Healthcare Community Plan (Medicaid)  may try to deny you based upon a lot of things such as weight, lack of symptoms, lack of previous medical management, and lack of enough tissue that should be removed. 
Read the Medicaid certificate of coverage. Determine what medical information is required for Medicaid to issue a pre-authorization or predetermination of benefits for BR surgery. The lactation process should be complete prior to breast surgery.  Consult with a board certified PS 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 by the insurance provider.  
Kenneth Hughes, MD, Board Certified Plastic Surgeon
Los Angeles, CA

It's possible to have a second breast reduction, but sometimes patients can have slower wound healing and possible tissue loss, so Be sure to discuss your goals and concerns with your board certified plastic surgeon and consider the pros and the cons. Be certain your surgeon is properly certified.  I've attached a link where you can start your search. Without an exam, it will not be possible to fully evaluate you and give you recommendations. 

Thank you for your question and photo,             
The Bellesoma Method is a current technique to lift and/or reduce breasts without using implants or the ugly vertical scars.  The incisions are hidden around the areola and in the inframammary crease. The vertical incision has been completely eliminated. The areola incision heals almost invisibly due to the fact that there is hardly any tension on the closure. With this particular technique, ducts are preserved along with nerve supply maintaining nipple sensation and the ability to breast feed. Because the breast is reshaped internally and is secured to your chest muscles, upper pole fullness is possible without an implant. Attached is a patient who underwent The Bellesoma Method. Please note that her tissue was used to create upper pole fullness and cleavage without any foreign materials (mesh, implants, etc).  Unfortunately, we do not accept insurance for breast reductions.  Dr. Horndeski does not remove enough breast tissue to meet insurance criteria.  Instead, he utilizes the breast tissue to reshape the breast.  It is a proprietary technique that only surgeons that have been trained by me can perform. I hope this helps. 
Best wishes and kind regards, 
Dr. Gary Horndeski