Am I able to get Medicaid to pay for a Breast Reduction?

Question

My chest is so Heavy and I have asthma. Can I have my breasts reduced due to asthma?

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.
You may be an excellent candidate for breast reduction surgery at some point; this operation tends to be one of the most patient pleasing operations performed. If you are not at a long-term stable weight, it will be in your best interest to reach this weight prior to undergoing breast reduction surgery.
Unfortunately, it may be very difficult to find the highest quality of care if you are seeking  to have the operation covered through Medicaid. Many plastic surgeons no longer work with this organization given the bureaucratic hassles involved ( and extremely low reimbursement rates).
 Given that your first priority should be safety as well as outcome of the procedure, you may do better by gradually saving up for the procedure and/or obtaining an alternative form of health insurance.
I hope this helps.

Jeffrey Zwiren, MD · Answer

The only way to know for sure if Mediaid will cover your breast reduction is for you to be examined by a plastic surgeon and then medical necessity can be determined.

Lee E. Corbett, MD · Answer

If your medicaid plan is like standard insurance companies, you will have to demonstrate that your reduction is medically necessary. They will want to know your height, weight, how much is going to be removed from each breast, your symptoms, and what conservative treatments you have tried (weight loss, non steroidal drug trials, support bras, physical therapy, chiropractors). Larger breasts are not typically associated with making asthma worse so I am not sure asthma would be of much help for you. Your surgeon will have to submit all of your information to your insurance company and ultimately they will decide.

Am I able to get Medicaid to pay for a Breast Reduction?

Answers (3)

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