Can Healthfirst cover my breast reduction if I'm a 38D?

Question

Im 18, weight 157 lbs and my breast are a 38D. I would really like to be a B or a small C cup, lately I've been feeling pain in my back and on the sides of my breast. It's to exercise cause they feel so heavy.

Larry S. Nichter, MD, MS, FACS · Answer

From your description it seems as if you are a good candidate for breast reduction. Unfortunately, each insurance company has their own criteria. Large breasts (macromastia) or breast hypertrophy can occur in a variety of conditions (family trait, post pregnancy, excessive adolescent growth). In general when the excessive breast size causes functional problems, insurance will generally pay for the operation if more than 400 – 500 grams are removed from each breast dependent on your individual insurance company requirements. These problems may include neck pain, back or shoulder pain, hygiene difficulty, and breast pain. Other problems which are less likely to be covered by insurance include skin irritation, skeletal deformity, breathing problems, psychological/emotional problems, and interference with normal daily activities. Pre-authorization by the insurance company is required prior to surgery, and the process takes approximately one month. Each insurance policy has different guidelines and exclusions.This procedure is commonly covered by insurance through insurance criteria are becoming more and more restrictive. Although we do not accept insurance, our staff will assist you in obtaining pre-authorization so that you can attempt to be reimbursed for out of pocket expenses

Reza Momeni, MD, FACS · Answer

It sounds like you're a good candidate for breast reduction, as long as your healthy.Coverage by insurance companies for breast reduction is NEVER based on cup size.  It's based on their policies for pre-existing problems, body surface area of the patient (you can calculate on the internet), estimate of the size of tissue the surgeon believes he/she will remove, and a number of other supporting documents.  Policies and procedures vary from one carrier to the next, and some policies just don't cover breast reduction, no matter what kind of problems you have.Ask your insurance company to send you their policy paper on breast reduction, and you will see what you need.

Sugene Kim, MD, FACS · Answer

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.

Eduardo Mejia, MD · Answer

Thanks for the question. As other doctor said before me answer you should contact your insurance company. i agree your young and losing weight may help even with the result.good luck!

Robert L. Kraft, MD, FACS · Answer

A D cup is a small reduction and this is likely not to be covered by insurance.  There are minimum gram weight requirements which you would not meet by going down to a large B or small C.  I would recommend that you try to lose weight as this might cause the breasts to become small enough to alleviate your pain. Try to exercise wearing a sports bra. Good luck!

Can Healthfirst cover my breast reduction if I'm a 38D?

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Answer: Can Healthfirst cover my breast reduction if I'm a 38D?

Answer: Can Healthfirst cover my breast reduction if I'm a 38D?

Answer: Does Healthfirst cover D cup breasts?

Answer: Does Healthfirst cover D cup breasts?

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Can Healthfirst cover my breast reduction if I'm a 38D?

Answers (5)

Answer: Can Healthfirst cover my breast reduction if I'm a 38D?

Answer: Can Healthfirst cover my breast reduction if I'm a 38D?

Answer: Does Healthfirst cover D cup breasts?

Answer: Does Healthfirst cover D cup breasts?

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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.