Is It Possible to Get Peri Areolar Reduction Semi Covered Through Insurance?

     Unless the reduction through the areola would also remove several hundred grams of tissue, insurance would not cover the procedure.  They consider areola reduction cosmetic.

Tuberous, tubular, or constricted breasts are anatomic variations that some women find aesthetically unacceptable.  Correction is cosmetic and not covered by insurance.

Thank you for the question. Although tuberous breast is described as a form of breast deformity it is usually not covered by insurance companies. Generally speaking, insurance companies will look for medical necessity to approve a procedure. This could be in the form of back problems, mobility problems, recurrent infections, or breathing difficulty. " Emotionally crippling" is not one of their criteria. 

Your surgeon can submit a request to your insurance company and see the outcome. If it is denied, they will advise you in writing for the denial reason.

 

I believe you should be told the truth. There is 98% chance of a non covered decision for areolar reduction. We would be happy to operate but you have a responsibility of a fee. Yes try a teaching plastic surgery residency for more in expensive surgery. 

Although I understand your rationale, I think that you will likely end up wasting your time/efforts in trying to convince health insurance companies to cover your surgery.  We're finding it increasingly difficult to have even large breast reductions covered through health insurance companies; it is extremely unlikely that they will provide coverage for correction of tuberous breasts.

 Sorry, I cannot give you more hopeful advice.

 Best wishes.

I certainly feel your pain and anguish.   Unfortunately these types of congenital breast deformities are generally not considered to be a medically necessary procedure.  In a perfect world these conditions would be covered.  Seek the advice of a plastic surgeon so that you can understand the problem and find a solution to your problem.  

Hi.

1)  This is a very disturbing real congenital deformity, its correction should be considered medically necessary, and it should be covered, but unfortunately it is not covered by insurance.

2)  Surgery at the plastic surgery clinic of a teaching hospital is very inexpensive and quite safe.  In New York City, we run one at Lenox Hill Hospital.