How to qualify for a breast reduction?? (Medicaid)

I am sorry to hear about the problems your disproportionately large breasts cause.  Based on your description I think you are likely an excellent candidate for breast reduction surgery.I think the biggest challenge you may face is finding a reputable plastic surgeon who works with Medicaid.  Ultimately, careful selection of your plastic surgeon will be one of the most important decisions you make. I would suggest starting with the American Society of Plastic Surgery and/or the Aesthetic Society of Plastic Surgery to obtain a list of well experienced board-certified plastic surgeons.
Then, I would suggest you visit a few surgeons whose practices concentrate on aesthetic surgery. Ask to SEE lots of examples of their work AND preferably speak/see patients who have had similar procedures done.
Be very careful with your decision-making. You will find, while doing your due diligence, that there are many different “specialties” who will offer their services to you; again, I strongly recommend you concentrate on surgeons certified by the American Board of Plastic Surgery. I hope this, and the attached link, helps. Best wishes. 

Breast reduction can change your life and relieve your neck, back and shoulder pain.  Insurance does not always cover this procedure, it always depends on the policy for the individual insurance company including Medicaid.  See a board certified plastic surgeon, let them evaluate you and see if you are a good candidate.  It will be difficult to find an experienced plastic surgeon within the medicaid network.  Find a surgeon you are comfortable with and see what your options are. Good luck! 

Breast reduction may or may not be covered depending on your insurance
carrier and your breast size. Please check your insurance policy to see
whether breast reduction is a covered procedure. Often times,
insurance company will dictate how much breast tissue to be removed.
Please visit an experiences, board-certified plastic surgeon to learn
about the procedure, its cons and pros, benefits, and alternatives.
Please contact your insurance carrier to learn about inclusion and
exclusion criteria. Best wishes.

Every insurance plan has their own unique criteria on whether they will
cover a breast reduction. More and more, we are seeing plans where a
breast reduction is not a covered benefit. If it is a covered benefit,
some insurance plans set a minimum required amount of tissue to be
remove in order to met their threshold for coverage. Some set the amount
in relation to your BMI (height and weight). Others require extensive
medical records documenting neck pain, back pain, and history of rashes.
The other alternative is to opt for a breast reduction as a self-pay
option. Start by visiting with a board certified plastic surgeon to
learn more about your options.Best wishes,Dr. BasuHouston, TX

Dear Unpretty91,It really sounds like you are struggling with painful symptoms of macromastia (large breasts). A 36 DDD is very large on a 5'5" frame. You sound like an appropriate candidate for breast reduction surgery. Typically, breast reduction is performed for headaches, pain in the neck, shoulders, upper back, kyphosis (forward neck), bra strap grooving, and rashes attributable to the breasts. Generally several months of therapy, NSAIDs, and specialized bras are trialled; if the pain persists, your best option may be reduction surgery. Medicaid criteria vary but have been known to cover reduction surgery; you should seek the counsel of a plastic surgeon or academic center where Medicaid is accepted, and proceed from there. I really hope this helps and that you seek the help you deserve. Hopefully, in your next response, you change your name to Pretty91!Sincerely,