Steps to Breast Reduction?

Hi kendrakay97,
Yours is a great question. In general, women presenting for breast reduction consultation via insurance will have:1. Symptoms, including back and neck and shoulder pain, bra strap grooving, trouble finding clothes that fit, awkwardness in social situations, and others2. A documented history of multiple visits to primary care physician regarding large breasts.3. Potentially a documented history of multiple uses of physical therapy, massage therapy, and/or chiropractic therapy.
In order to have a useful visit with the surgeon, the above criteria should generally be met. During your visit with the surgeon, he or she will estimate the approximate removal weight, and will package a complete history and physical exam, along with anticipated removal weight, and documentation of numbers 1 through 3 above, when the insurance preauthorization letter sent. All of these together are no guarantee that the insurance will provide coverage for the surgery, but it certainly helps to of all your documentation intact for that original submission.
Hope this helps.
Best,Christopher Pannucci MDBoard Certified Plastic SurgeonPlastic Surgery NorthwestSpokane, Washington

You will want to first contact your insurance carrier to determine if breast reduction is a covered benefit under your policy. If it is you carrier may only work with certain surgeons, so you will need to access a list of those physicians. Most insurance carriers will require that certain criteria is met in order for the procedure to be approved. This may include things such as a minimum amount of tissue to be removed and proof of prior non surgical interventions. The criteria will vary by policy.

Thank you for your question. I would suggest doing some research on Board Certified Plastic Surgeon's who do Breast Reductions in your area. Schedule a consultation with them and ask if they accept insurance and or to reach to your insurance for you. You do not have to start a prior authorization on your own. You could also reach out to your insurance company to see if there are any Board Certified Plastic Surgeons in network as well. Best of luck to you on this journey.