Will medicaid cover for my Breast Reduction?

Question

Im am 19 years old......and my bra size is an 42H..I've been trying to loose weight so many times I currently weigh 154 lbs but I've been having back problems and shoulder problems I've been thinking would my Medicaid be able to pay for my breast reduction ?

Vincent N. Zubowicz, MD · Answer

Medicaid will cover breast reduction if there is a functional impairment. You'll have to find a surgeon who accepts Medicaid and he can inquire on your behalf.

C. Bob Basu, MD, MPH, FACS · Answer

Every insurance plan has their own unique criteria on whether they will cover a breast reduction. More and more, we are seeing plans where a breast reduction is not a covered benefit. If it is a covered benefit, some insurance plans set a minimum required amount of tissue to be remove in order to met their threshold for coverage. Some set the amount in relation to your BMI (height and weight). Others require extensive medical records documenting neck pain, back pain, and history of rashes. The other alternative is to opt for a breast reduction as a self-pay option. Start by visiting with a board certified plastic surgeon to learn more about your options.Best wishes,Dr. BasuHouston, TX

Tom J. Pousti, MD · Answer

Thank you for the question. Based on your description, you may be an excellent candidate for breast reduction surgery; this operation tends to be one of the most patient pleasing operations we perform.Although this procedure may be covered through Medicaid, I think the biggest challenge  you may have is finding a reputable plastic surgeon who works with Medicaid.  You may find the attached link helpful to you as learn more about the procedure. Best wishes.

Arun Rao, MD · Answer

Thank you for your question. Medicaid does cover breast reduction if you meet the appropriate criteria. I would look for a board certified plastic surgeon in your area that takes your insurance. Good luck

Ronald V. DeMars, MD (Retired) · Answer

You would need an exam to determine that, but under the right circumstances Medicaid does cover the procedure. Unfortunatly, the reimbursement is so low that it will be hard to find a doctor who can afford to do the surgery.

Will medicaid cover for my Breast Reduction?

Answers (5)

More Breast Reduction Questions

I noticed an odor from right breast incision, causing leakage and offensive smell. Is this normal? (photos)

What is the absolute flattest breast reduction I can get without transitioning to male?

Is it normal to have a fever after Breast Reduction? I had mine Thursday, came home Friday. 99.4 now it is 100.

I have just been diagnosed with IBS, will this have any impact on my breast reduction?

Are drains or a urinary catheter necessary?

I'm 13 yrs old, 42 D, and my breasts are sagging. What's wrong with them and is there any way to fix them?

WE SEND PRETTY
EMAILS