What is the likelihood breast reduction surgery will be covered under insurance? (Photo)

I'm a tall girl, a little over 6' to be exact, and I weigh roughly 150 and have 32DDs. I've always had a smaller frame and large breasts, and I am constantly experiencing back and neck pain on a daily basis. I'm also very active and have been an athlete my entire life, so strengthening my muscles is not new news to me. What are the chances insurance would cover a breast reduction under my circumstances?

Doctor Answers 2

Will Insurance Cover Breast Reduction

Coverage will depend on your policy. Some cover some don't, the ones that do have certain criteria you need to meet for them to cover. In most cases, you need to have 500 grams or more removed from each breast to qualify, and that usually equates to a DD cup size. Also, many insurance companies want documentation of what you have tried already to alleviate your symptoms, such as; physical therapy, special bras, analgesics, etc. I recommend that you find a Board Certified Plastic surgeon who specializes in breast surgery who can help you get authorization. Good luck!


San Francisco Plastic Surgeon
4.8 out of 5 stars 68 reviews

Breast Reduction Surgery

Thank you for your question. Your first step would be to find a board certified plastic surgeon that accepts your insurance and set up a consultation with him/her. Then they would be able to examine you and take pictures for insurance purposes. Most insurance require a certain amount of weight to be able to be removed from the breasts to even be considered.The physicians office will then send a consideration letter to your insurance provider. It then is just a waiting game to see if you are approved. If you do get approved, still expect to have some out of pocket cost to you.

Lawrence Bundrick, MD
Huntsville Plastic Surgeon
5.0 out of 5 stars 6 reviews

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.