I have constant neck, upper back, and shoulder pain from 36F breasts, and I basically never lose any weight there no matter what. My question is, what is the best detailed, step by step procedure to working with insurance to get this surgery covered? What is the first, second, third, etc., thing that you should do? I know that people have gotten Kaiser Permanente to cover their surgery (that's what I have), but it was not easy and I don't know what their EXACT steps were. Thanks for all advice.
April 12, 2017
Answer: Steps to get insurance to cover my breast reduction Thank you for your question and there is no secret to getting this approved. Since you have Kaiser, you will need to see their plastic surgeons and have them determine if they will cover your surgery otherwise you will have to pay for this yourself. I have found Kaiser not unreasonable in approving this surgery for their patients if you fit their criteria.
Helpful
April 12, 2017
Answer: Steps to get insurance to cover my breast reduction Thank you for your question and there is no secret to getting this approved. Since you have Kaiser, you will need to see their plastic surgeons and have them determine if they will cover your surgery otherwise you will have to pay for this yourself. I have found Kaiser not unreasonable in approving this surgery for their patients if you fit their criteria.
Helpful
June 8, 2017
Answer: Breast reduction surgery 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 (as you are doing). 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!
Helpful
June 8, 2017
Answer: Breast reduction surgery 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 (as you are doing). 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!
Helpful
