Breast Reduction on Medicare with 34G Bust. (photos)

Ive seen PS in regards to BR, he advised I may be able to get this procedure done through Medicare, is this correct? Im 50, 163cm tall and weigh approx 65kg and 30inches at my ribs, medium frame. I have large Pseudoptosis breast and he suggested an anchor incision. I suffer from neck arthritis, shoulder grooves, shoulder issues and back pain. I no longer swim, its embrassing! From my photo, do you think I would be approved?

Doctor Answers 2

Breast Reduction on Medicare with 34G Bust.

Thank you for the question and congratulations on your decision to proceed with breast reduction surgery; this operation tends to be one of the most patient pleasing operations we perform. Based on your description, it sounds like you may be an excellent candidate for the procedure.  


Best to check directly with your insurance company or entity to see whether breast reduction surgery is a “covered” benefit with your specific policy. Then, given that every insurance company has different “criteria”, best to identify exactly what your specific insurance company considers criteria for approval. Generally, the more documentation you have (for example, from your primary care doctor, physical therapist, chiropractor etc.) the better when it comes to obtaining insurance “authorization” for the procedure. Also, for many insurance companies, the closer you are to your long-term ideal weight, the better.

This documentation and letter/pictures from your plastic surgeon will help you obtain authorization. Keep in mind, as you work towards your goals breast reduction surgery is one of the most patient pleasing operations we perform. 

Also, prepare to be persistent when dealing with health insurance companies. I hope this, and the attached link (dedicated to breast reduction surgery concerns), helps. Best wishes.

#breastreduction

Hi.  You would certainly be eligible for an item number under medicare for the procedure.  The problem is that it is no longer offered as an operation in most public hospitals so therefor it is not free.  You would need to take out private insurance and this will reduce your costs by about half if you proceed in the private sector.  In my hands you would likely be suitable for a minimal scar breast reduction - see link below.

Regards
Damien

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.