Do you think BCBS State (SC) will pay for a Breast reduction?

Question

43yr old 5'4" weighing 179lbs. Currently in a 40DDD. I have severe neck, shoulder (with deep grooves), and back pain. Have been through chiropractic care, exercising routine, wide/padded bra straps, pain meds, anti-inflammatory meds, etc. Only had one biological birth w/2 wks breast feeding. Lost all baby weight but not breast. Had total hysterectomy at 27 due to severe episodes of endometriosis. In seek of breast reduction and lift at same time. Would like to go from 40DDD to possibly a 40C.

Laura Randolph, MD · Answer

It sounds like you would be a good candidate for breast reduction surgery.  The first step would be consulting with a physician, and then they would need to submit your information to BCBS to see if it can get approved.  Each insurance company had different guidelines how many grams of breast tissue have to be removed to make it medically necessary, and for insurance to cover.  From your BMI it would be a fairly realistic goal to be able to get down to a C, and take enough grams out.  As far as a lift, the breast reduction surgery includes a lift of mastopexy.  When you consult with a physician they should be able to discuss with you what the breast reduction will entail.

Louis Potyondy, MD · Answer

If you meet the criteria, then the insurance should cover it. The best thing to do is to come in to the office and we can submit it to insurance.best of luck!

William Lambeth, MD (retired) · Answer

I think you might well qualify for a breast reduction. You have the required size and approriatre symtoms. Basically if you are big enough and have not improved with conservative treatments like special bras , chiropractic care, and antiinflamatory meds,you are a good candidate The breast size usually goes down 50 -60 %with a reduction,but can't guarantee a "C",maybe a small "D". Most patients get significant pain reduction. By the way, breast lift is part of a breast reduction.

Do you think BCBS State (SC) will pay for a Breast reduction?

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Do you think BCBS State (SC) will pay for a Breast reduction?

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Everything you need to know about Breast Reduction

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