I had a breast reduction in BC over 10 years ago and require another. Would it be covered?

It may be covered if your symptoms have returned. You can call your insurance company to find out what the general policy is. It would be even better if you see a plastic surgeon who can evaluate you, and send their assessment to your insurance company. Then you will know for sure. Be sure to find someone who is board-certified, and who you are comfortable with. Good luck in the process!

I it would covered if you are having similar symptoms.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable.  Additionally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery, a member of the American Society of Plastic Surgery (ASPS) and the American Society of Aesthetic Plastic Surgery (ASAPS).
Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon 

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
#breastreduction#reduction

If you are writing from Canada, the answer may be yes. I have heard from Canadian surgeons their NHS has fairly relaxed criteria for breast reduction. In the U.S., it totally depends on your symptoms and the plan you have. Some U.S. plans completely exclude breast reduction. Either way, consultation with a board certified plastic surgeon will help you get the answers.

Hello and thank you for your excellent question. Unfortunately, dealing with insurance companies is often a challenging task. Your best option to see if your procedure is covered, is to contact your insurer to get details about coverage and requirements before approval for surgery. Given the difficulties of dealing with insurance, you can consider paying out of pocket for the surgery. For our patients, the out-of-pocket expenses for an insurance plan often approximate (or even exceed) the cost for the procedure. You can then obtain documentation from your surgeon to attempt to get reimbursement from your insurer. Any treatment plan should be based on a detailed discussion with equal input from both you and your surgeon.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   Preoperative visualization and surgical simulation with the Crisalix system may help with your decision. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation in person with a qualified board-certified plastic surgeon. Good luck! 

Best,

Jon Ver Halen, MD FACS 

Harvard educated plastic surgeon

Possibly, but the only way to tell would be to have a consultation and then the surgeon will contact the company to see if you meet their criteria.