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.
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.
Helpful
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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