I am 23 years old, 5'3, and 150 lbs. Since I was 15 I have experienced constant stress and pain in my shoulders/neck, as well as soreness in my pectoral muscles when I go without a bra. The muscles in my shoulders/neck are sore and tense, especially in the area where my bra straps are constantly digging in. I am curious as to the chances of my Kaiser insurance finding me qualified for coverage for the surgery and gathering professional opinions. Thank you!
December 17, 2017
Answer: Will Kaiser (or any insurance) Cover the Cost of a Breast Reduction? Symptoms of neck and upper back pain, irritation under the breasts, failure to improve symptoms with weight loss (if needed), and duration for more than about six months seem to be what insurance companies are looking for when they approve breast reduction. The amount to be removed does not have to be an arbitrarily large amount, e.g., over 500 cc, in the scientific literature, but some insurance companies may still try to put a minimum number to give approval. Patients who want to try to get insurance company coverage need to have a personal consultation with a board-certified plastic surgeon, and have a letter describing the factors above and usually photographs sent in.Kaiser is it's own insurance company, and you should go in to see the plastic surgeon there and you can find out directly. Every insurance company deals with the issue as they wish, there are no standardized rules or regulations for this. Your plastic surgeon can help you provide them the needed documentation. If you want any insurance coverage, you must get them to approve it in writing before having the surgery.
Helpful 2 people found this helpful
December 17, 2017
Answer: Will Kaiser (or any insurance) Cover the Cost of a Breast Reduction? Symptoms of neck and upper back pain, irritation under the breasts, failure to improve symptoms with weight loss (if needed), and duration for more than about six months seem to be what insurance companies are looking for when they approve breast reduction. The amount to be removed does not have to be an arbitrarily large amount, e.g., over 500 cc, in the scientific literature, but some insurance companies may still try to put a minimum number to give approval. Patients who want to try to get insurance company coverage need to have a personal consultation with a board-certified plastic surgeon, and have a letter describing the factors above and usually photographs sent in.Kaiser is it's own insurance company, and you should go in to see the plastic surgeon there and you can find out directly. Every insurance company deals with the issue as they wish, there are no standardized rules or regulations for this. Your plastic surgeon can help you provide them the needed documentation. If you want any insurance coverage, you must get them to approve it in writing before having the surgery.
Helpful 2 people found this helpful
January 21, 2019
Answer: Breast Reduction and Kaiser Insurance It is very possible that Kaiser will cover your breast reduction surgery, but it will depend on their guidelines. You need to see your primary care physician and get a referral to a plastic surgeon. Good Luck!!
Helpful
January 21, 2019
Answer: Breast Reduction and Kaiser Insurance It is very possible that Kaiser will cover your breast reduction surgery, but it will depend on their guidelines. You need to see your primary care physician and get a referral to a plastic surgeon. Good Luck!!
Helpful
