Is there any way I could possibly get medicaid to pay for the reduction?

Question

I'm a 24 year old woman. I'm 5'7" and weight about 225 lbs. I'm in a size 42 H bra and I would really love a reduction. My back, shoulder, neck, and head hurt alot. I'm a single mom and its an semi expensive procedure.

Kenneth Hughes, MD · Answer

From your symptoms, you appear to be a good candidate for a BR.  Additional information and an office consultation would be required to offer an accurate assessment.  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, your insurance company may try to deny you based upon a lot of things such as weight, lack of enough tissue that should be removed, lack of symptoms, and lack of previous medical management.
Read your medical insurance certificate of coverage. Determine what medical information is required for your insurance provider to issue a preauthorization or predetermination of benefits for BR surgery. Then seek consultation with a board certified plastic surgeon who can evaluate your medical condition, discuss the pros and cons of this surgery as it applies to you, and help you in completing the paperwork required by your insurance provider.  Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Reza Momeni, MD, FACS · Answer

Medicaid does cover breast reduction if it's medically  necessary, unless you have one of the Medicaid policies that exclude it.  You should contact the number on your insurance card to inquire.

Daniel Barrett, MD · Answer

Dear nikki_fuze,
Many women have overdevelopment of breast tissue and require reductions even younger than 24 years old some times.  Some of the questions you need to ask yourself are if you are willing to have scars from the surgery, take the risk of losing nipple sensation and other complications in addition to possible problems breast feeding if you plan to have children in the future. 
Based on your description it sounds like you are a good candidate for a breasts reduction. I would meet with a plastic surgeon to go over all of these risks and benefits to see if you would be a good candidate for surgery.
Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Is there any way I could possibly get medicaid to pay for the reduction?

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Is there any way I could possibly get medicaid to pay for the reduction?

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