My currently wear 34G bra. Would I qualify for insurance coverage of breast reduction?

Based on your stated height and weight, the Schnur formula would require the removal of at least 460g per breast in order to qualify for breast reduction insurance coverage. (That assumes you have the other subjective criteria.)Since 454g = 1 pound, you would require the removal of just over one pound per breast to obtain coverage. One or two grams too little removed means you would NOT qualify and your insurance would deny coverage. This means you would get the ENTIRE bill, even if  you were just barely under the minimum required resection.So take a pound of anything and see how that compares to your breasts, and more importantly, how much breast that would LEAVE BEHIND!Density is relative, since a pound of lead weighs exactly as much as a pound of feathers. No matter the density, you need to have at least 460 (and I would add another 5-10 g just to be on the safe side) grams removed per side.I have found that even though insurers require a certain amount of tissue removal, patients are much more concerned with the amount of tissue that remains.One way I demonstrate this to patients is to figure the Schnur formula based on the patient's height and weight, and once I have the number (in your case 460g), then I give them a 460cc implant and ask them to imagine that amount of tissue removed from each breast, one of which they can hold in their other hand. This will give you the answer, and you can always ask for a "cosmetic" (any size removed you wish) breast reduction or breast lift instead. Of course, you then must pay for elective surgery. Best wishes! Dr. Tholen

Thank you for your question. Yes, in my opinion you would be a good #candidate for a #breast #reduction surgery. Candidates for #BreastReduction surgery
are women who wish to have smaller #breasts to achieve a more proportional
appearance or to alleviate physical discomfort. Breast reduction can correct
symptoms from excessively #largeheavybreasts that may cause the inability to do
certain exercises, or create back, shoulder and neck pain, poor posture,
bra-strap shoulder indentations and chafing or rashes under the breasts. Women
experiencing these discomforts may benefit from Breast Reduction, also called #ReductionMammoplasty.
Furthermore, large breasts may interfere with normal daily activities or
exercise and will be more comfortable when reduced. Women who feel that their
excessive breast size decreases a sense of attractiveness and self-confidence,
or results in unwanted attention are also candidates. This procedure is commonly covered by insurance
though 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

#PlasticSurgery #BreastReduction
#Insurancecoverage

Every insurance company has their
own policy regarding #reduction coverage. The best thing to do is schedule a
visit with a plastic surgeon who can contact your insurance company for
authorization after performing a #breast examination and documentation of your
symptoms. You should also consider going to your primary physician for an
examination and documentation as well. Insurance companies have a number of
requirements and an examination will be able to determine if you are a
candidate for reduction.

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 i 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 though 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. Best wishes!

Hello and thank you for your question. Based on your bra size and height and weight, you should be an outstanding candidate for a breast reduction. The most important aspect is to find a surgeon you are comfortable with. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.Best wishes and good luck.Richard G. Reish, M.D.Harvard-trained plastic surgeon