Will breast reduction only on one side be covered by insurance? (Photo)

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.

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.  

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.

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. 

1. Insurance:  I cannot answer that question.  We might both think insurance should provide benefits to have the surgery and we may be right, but that will not influence what the insurance company will do.  2. Is there an answer or solution that can really help you?  Yes!  I do feel for you, as having severe breast asymmetry is very uncomfortable and disabling and psychologically traumatizing.  3. What can be done?  If the smaller breast size is comforable and acceptable for you, the larger breast can be reduced with minimal scar approach to create better symmetry.4. You might find this article on teen breast reduction helpful.  Good luck.

I believe that you should be covered by insuranceYou have symptomatic mammomegaly  andPolands syndromeBe persistent with you insurance company    

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.

It is likely that your insurance company will cover the breast reduction, but you need to check it out with your insurance company.

Yes a very good chance but you need in person examination by boarded PSs in your area to send to your insurance carrier for predetermination letter..... 

Insurance authorization is based on objective criteria.Your insurance company can give you their specific criteria for when they cover breast reduction.When I obtain authorization for breast reduction surgery, I try to address each one of the criteria needed to obtain approval.While some requests get denied, it's usually for a specific reason that can be readdressed. It is important that you have a plastic surgeon who will be your utmost advocate.It should not matter if one breast is large or both breasts are large. What matters is if your diagnosis matches the correct procedure.In your case, the diagnosis still needs to be neck and back pain, not breast asymmetry.If authorization is requested to treat breast asymmetry, it will most likely be denied. If authorization is requested to treat neck and back pain or skin irritations, it is highly likely that it should be authorized.Don't be frustrated or think it's final if you get a denial. It sometimes requires back-and-forth communication.Look for an experienced board-certified plastic surgeon. If that person is not successful in getting authorization, you may need to consult with the second one.Best of luck,Mats Hagstrom, M.D.