Will Medicare Cover Breast Reduction for a 60 Year Old?

Question

Hi.   I am a 60 year old female with OA, PMR and GCA. I've also had stents placed in the coronary arteries and angioplasty.  I am a size 38DDD, could probably go to and F.
I've had a yeast infection under both breast, a constant odor, severe neck and back pain and grooves in both shoulders. Will Medicare cover this procedure?

Tom J. Pousti, MD · Answer

Thank you for the question.

Given your description, it is very likely that Medicare will cover each breast reduction procedure. Consultation with a well experienced board-certified plastic surgeon will be helpful. Also, consultation with your cardiologist should also be  considered for a full workup prior to surgery.

Best wishes.

Otto Joseph Placik, MD · Answer

I think Dr. Whitt has summarized the salient points excellently. It is likely that your procedure will be covered. The next decision is if your medical health is optimized. The third issue is a matter of risk assesment and you willingness to accept possible complications as a tradeoff for the potential benefits.

Jeffrey Zwiren, MD · Answer

Unfortunately Medicare does not pre-approve anything.  If you meet the generally accepted criteria then most likely Medicare will pay but there is no guaranty.  You should have medical clearance from your cardiologist prior to even considering a breast reduction.

Steven Wallach, MD · Answer

Each insurance carrier has different criteria for pre-approval of a breast reduction. You should check with your insurance carrier. Check with medicaid

Darryl J. Blinski, MD · Answer

Yes, Medicare will cover breast reduction if you meet their criteria. A predetermination letter with photos can help you achieve the ok for the surgery. Your main issue is if you are medically cleared to under go this operation or any operation. Please ckeck with your primary and cardiac docs.

Will Medicare Cover Breast Reduction for a 60 Year Old?

Answers (8)

Answer: Insurance and breast reduction

Answer: Insurance and breast reduction

Answer: Medicare will cover Breast Reduction if you meet their criteria

Answer: Medicare will cover Breast Reduction if you meet their criteria

Recommended reading

Everything you need to know about Breast Reduction

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

Will Medicare Cover Breast Reduction for a 60 Year Old?

Answers (8)

Answer: Insurance and breast reduction

Answer: Insurance and breast reduction

Answer: Medicare will cover Breast Reduction if you meet their criteria

Answer: Medicare will cover Breast Reduction if you meet their criteria

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Recommended reading

Everything you need to know about Breast Reduction

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