I'm Ashley. I am 20 yrs old. How do I go about insurance to help pay for my reduction and lift surgery?

I am a 44DD and when I bend over I have sharp back pain I bought every type of bra I can think of even tried smaller and bigger size bras even tried losing weight and lifting weight to uplift them to reduce back pain it do not work everything I natural I tried just don't work how do I go about getting insurance do they have payment plans to cover the surgery

Doctor Answers 5

BR and insurance

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Under certain circumstances Breast Reduction is covered by insurance. Unfortunately, each insurance company has their own criteria. Large breasts (macromastia) or breast hypertrophy can occur in a variety of conditions (family trait, post pregnancy, excessive adolescent growth). In general when the excessive breast size causes functional problems, insurance will generally pay for the operation if more than 400 – 500 grams are removed from each breast dependent on your individual insurance company requirements. These problems may include neck pain, back or shoulder pain, hygiene difficulty, and breast pain. Other problems which are less likely to be covered by insurance include skin irritation, skeletal deformity, breathing problems, psychological/emotional problems, and interference with normal daily activities. Pre-authorization by the insurance company is required prior to surgery, and the process takes approximately one month. Each insurance policy has different guidelines and exclusions.
This procedure is commonly covered by insurance through insurance criteria are becoming more and more restrictive. Although we do not accept insurance, our staff will assist you in obtaining pre-authorization so that you can attempt to be reimbursed for out of pocket expenses

Breast Reduction and Insurance

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It sounds like you have tried most of the recommended solutions that insurance companies request. Your best bet is to see a Board Certified Plastic Surgeon who specializes in breast surgery. Your surgeon will know how to apply for pre-authorization for you. It will help if you have documentation of what you have tried so far, i.e. the purchase of special bras, physical therapy, a doctors report confirming your attempts and your continued symptoms. Good luck!

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 81 reviews

How do I go about insurance to help pay for my reduction and lift surgery?

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Insurance questions are best directed toward your insurance company- best to start with your employer. Generally speaking, Plastic Surgeons do not have detailed intimate insurance plan knowledge. Most Practices offer financing if a patient qualifies.

I'm Ashley. I am 20 yrs old. How do I go about insurance to help pay for my reduction and lift surgery?

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Unless you have read the exact policy with its restrictions of your heath insurance there is no way we can respond. Best to call the heath insurance company give your plan # and see if you are covered and what is required to obtain that coverage.

Insurance coverage of breast reduction

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Thank you for your question. With breast reduction surgery there is always a "lift" involved. The only difference is routinely you have a significant amount of tissue (weight) removed with a reduction, hence the name. In my practice approximately 95% of breast reductions are covered by health insurance. There are major differences between insurance companies, but if enough tissue is removed then the operation is considered a reconstructive procedure not a cosmetic procedure. We consider it an added "bonus" that your breast look better after reduction surgery. Breast reduction patients are the happiest and most satisfied surgery patients we encounter day to day. You will look and feel so much better. I wish you luck!

Eric E. Wegener, MD
Jackson Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.