Keystone First : How can I get them to pay for a breast reduction

Question

I am 27, 5'5 and weigh an even 200 lbs. I have crucial back, shoulder, and neck pain. I also have dents in my shoulders and a reoccurring rash in between my breast. What steps should I take in order to get full coverage from my insurance company, Keystone First. I really need this procedure.

Michael J. Denk, MD, FACS · Answer

The first thing to do is to see your primary care physician so he can documents your complaints and start the appropriate “paper trail”. Secondly, call your member services department and inquire about the exact requirements needed to precertify a breast reduction. Most insurance carriers require strict documentation followed by a request for surgical preauthization by your plastic surgeon. It’s a process, but is very much worth it. Best of luck!

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