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
