I'm 18 years old, 5'1", and 150 lbs. my left breast is a size DDD, if not larger. My right breast is a B cup. I constantly have neck pain, headaches, and I can't sleep on my stomach because my left breast is always sore. I do not have one bra or bathing suit that fits correctly. I want to know if insurance would cover me getting a reduction of only one breast.
Answer: Unilateral breast reduction Insurance should cover the correction of this condition. You have all the symptoms that would make this a medical condition and not a purely cosmetic one. In addition if the hypertrophy is due to a fibroadenoma or other breast mass, as opposed to simply juvenile breast hypertrophy, this would warrant excision.
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Answer: Unilateral breast reduction Insurance should cover the correction of this condition. You have all the symptoms that would make this a medical condition and not a purely cosmetic one. In addition if the hypertrophy is due to a fibroadenoma or other breast mass, as opposed to simply juvenile breast hypertrophy, this would warrant excision.
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February 1, 2015
Answer: Will breast reduction only on one side be covered by insurance? Thank you for the question. Best to check directly with your insurance company to see whether breast reduction surgery in general is a “covered” benefit with your specific policy. Then, given that every insurance company has different “criteria”, best to identify exactly what your specific insurance company considers criteria for approval. Generally, the more documentation you have (for example, from your primary care doctor, physical therapist, chiropractor etc.) the better when it comes to obtaining insurance “authorization” for the procedure. Also, for many insurance companies, the closer you are to your long-term ideal weight, the better. This documentation and letter/pictures from your plastic surgeon will help you obtain authorization. Keep in mind, as you work towards your goals breast reduction surgery is one of the most patient pleasing operations we perform. Also, prepare to be persistent when dealing with health insurance companies. I hope this, and the attached link, helps. Best wishes.
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February 1, 2015
Answer: Will breast reduction only on one side be covered by insurance? Thank you for the question. Best to check directly with your insurance company to see whether breast reduction surgery in general is a “covered” benefit with your specific policy. Then, given that every insurance company has different “criteria”, best to identify exactly what your specific insurance company considers criteria for approval. Generally, the more documentation you have (for example, from your primary care doctor, physical therapist, chiropractor etc.) the better when it comes to obtaining insurance “authorization” for the procedure. Also, for many insurance companies, the closer you are to your long-term ideal weight, the better. This documentation and letter/pictures from your plastic surgeon will help you obtain authorization. Keep in mind, as you work towards your goals breast reduction surgery is one of the most patient pleasing operations we perform. Also, prepare to be persistent when dealing with health insurance companies. I hope this, and the attached link, helps. Best wishes.
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March 14, 2016
Answer: It is possible He would need to me with a board certified plastic surgeon who could Cindy her information on to your insurance carrier along with photographs to get a pre-determination uncoverage. I think given the massive size of her left breast that this would probably work for you, one never can guarantee what an insurance company will do.
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March 14, 2016
Answer: It is possible He would need to me with a board certified plastic surgeon who could Cindy her information on to your insurance carrier along with photographs to get a pre-determination uncoverage. I think given the massive size of her left breast that this would probably work for you, one never can guarantee what an insurance company will do.
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February 1, 2015
Answer: Massive Asymmetry of Breasts "Should" Be Covered By Insurance! Your left sided breast reduction should be covered. You will definitely need enough tissue removed on left side to qualify. You must discuss this with you insurance carrier. I have performed similar breast reductions, along with augmentations on the smaller side and the claim was refused based on a decision by the insurance carrier that it was a cosmetic procedure. Remember they don't always base decisions on what is best for the patient, but what will save the company money. Hopefully your insurance company is reasonable as you clearly deserve coverage for symptomatic macromastia even if it is only on one side.
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February 1, 2015
Answer: Massive Asymmetry of Breasts "Should" Be Covered By Insurance! Your left sided breast reduction should be covered. You will definitely need enough tissue removed on left side to qualify. You must discuss this with you insurance carrier. I have performed similar breast reductions, along with augmentations on the smaller side and the claim was refused based on a decision by the insurance carrier that it was a cosmetic procedure. Remember they don't always base decisions on what is best for the patient, but what will save the company money. Hopefully your insurance company is reasonable as you clearly deserve coverage for symptomatic macromastia even if it is only on one side.
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January 27, 2022
Answer: Single Side Breast Reduction Will insurance cover single side breast reduction? The answer is maybe. It depends on your insurance policy and in part on what supporting health information you have. Some policies exclude breast reduction all together while others require documented health issues (such as back pain) prior to approval. Your first step should be to discuss benefits with your insurance carrier and then find a surgeon that participates with your insurance. Based on your photo and description I would think you would have a reasonable chance of having the procedure covered, but ultimately it will depend on your policy.
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January 27, 2022
Answer: Single Side Breast Reduction Will insurance cover single side breast reduction? The answer is maybe. It depends on your insurance policy and in part on what supporting health information you have. Some policies exclude breast reduction all together while others require documented health issues (such as back pain) prior to approval. Your first step should be to discuss benefits with your insurance carrier and then find a surgeon that participates with your insurance. Based on your photo and description I would think you would have a reasonable chance of having the procedure covered, but ultimately it will depend on your policy.
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