My insurance is not going to cover breast reduction despite 38H's and many longstanding physical issues.t's a long story as to why, but they won't. So here's the question.You have to jump through many hoops if you're trying to get insurance to cover the surgery.How much of it has to be done if you are paying cash? Which presurgery procedures are needed vs what the insurance company wanted done? How long do you have to wait for the surgery? Do you still need statements from your PCP? Thanks! :)
November 11, 2017
Answer: Self pay -vs- insurance coverage for breast reduction? The procedure itself does not change regardless of how its costs are managed. Many patients undergo 'cosmetic' breast reduction for improved aesthetics similar to a breast lift. Each insurance plan is different, and many have exclusions for breast reduction surgery. This is unfortunate, because this procedure often affords many functional benefits that go beyond the positive of a much better breast shape. As with any elective procedure, you will have to meet standard health criteria for surgery. A mammogram is often recommended if you are 40 years or older, have significant risk factors, or a strong family history of breast cancer. Even as a 'cosmetic' reduction, I strongly recommend that patients send the removed breast tissue for examination by a pathologist. Insurances will sometimes cover this expense, even if the procedure itself was not approved.
Helpful
November 11, 2017
Answer: Self pay -vs- insurance coverage for breast reduction? The procedure itself does not change regardless of how its costs are managed. Many patients undergo 'cosmetic' breast reduction for improved aesthetics similar to a breast lift. Each insurance plan is different, and many have exclusions for breast reduction surgery. This is unfortunate, because this procedure often affords many functional benefits that go beyond the positive of a much better breast shape. As with any elective procedure, you will have to meet standard health criteria for surgery. A mammogram is often recommended if you are 40 years or older, have significant risk factors, or a strong family history of breast cancer. Even as a 'cosmetic' reduction, I strongly recommend that patients send the removed breast tissue for examination by a pathologist. Insurances will sometimes cover this expense, even if the procedure itself was not approved.
Helpful
November 11, 2017
Answer: No hoops if you are paying for breast reduction Self pay eliminates all the hoops for breast reduction. All you need is the best plastic surgeon, see them and be cleared by them for surgery, and proceed to get this done. Usually the very top plastic surgeons aren't taking insurance anymore (because the reimbursement is so very low) so you will probably get a better result by not using insurance.
Helpful
November 11, 2017
Answer: No hoops if you are paying for breast reduction Self pay eliminates all the hoops for breast reduction. All you need is the best plastic surgeon, see them and be cleared by them for surgery, and proceed to get this done. Usually the very top plastic surgeons aren't taking insurance anymore (because the reimbursement is so very low) so you will probably get a better result by not using insurance.
Helpful
