When will health insurance cover a breast augmentation?

I have struggled since puberty with accepting my body. My left breast is a C cup. My right is barely an A, and also deformed. I have always wanted to get it fixed so that they are both the same size at least. For years I have had to special order bras, and struggled with being intimate with anyone because I am ashamed of them. I'd like to find a way to correct them, hopefully with the help of my insurance. But at not sure where to begin or who to speak to about it.

Doctor Answers 18

Health Insurance and Breast Augmentation

Thanks for your inquiry.  This really depends on the health insurance you have, but in general, health insurance companies will not cover breast augmentation for cosmetic reasons.  However, if you do have a deformity such as tuberous breasts, they sometime will consider it more of a reconstruction than a cosmetic procedure and they may cover the cost of that.  So, you will have to find a plastic surgeon in your network and then see if you can get approved for the procedure.  Best of luck.

Health Insurance and Breast Augmentation

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Thanks for your inquiry.  This really depends on the health insurance you have, but in general, health insurance companies will not cover breast augmentation for cosmetic reasons.  However, if you do have a deformity such as tuberous breasts, they sometime will consider it more of a reconstruction than a cosmetic procedure and they may cover the cost of that.  So, you will have to find a plastic surgeon in your network and then see if you can get approved for the procedure.  Best of luck.

Highly unlikely

As a rule, insurance companies do not cover breast augmentations unless necessary to restore symmetry after a mastectomy for breast cancer.    I have not had any luck having insurance carrier cover asymmetry cases in non- cancer patients.    But there are many financing plans that might be able to help you.    

Highly unlikely

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As a rule, insurance companies do not cover breast augmentations unless necessary to restore symmetry after a mastectomy for breast cancer.    I have not had any luck having insurance carrier cover asymmetry cases in non- cancer patients.    But there are many financing plans that might be able to help you.    

Insurance for breast augmentation

In your.  Case you have a chance to get it covered but please do get your hopes up.  It also depends on what insurance you have.

Insurance for breast augmentation

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In your.  Case you have a chance to get it covered but please do get your hopes up.  It also depends on what insurance you have.

Breast size asymmetry

sometimes the larger breast will have more ptosis ( sagging ). The larger side could need a mastopexy ( breast lift ) or even a reduction mammaplasty ( reducing breast size usually with a " lift ).  or an augmentation of the smaller side could be enough to gain reasonable symmetry.  To get insurance to cover any of these procedures will need to be preauthorized as medically necessary which may or may not be granted.  photographic documentation along with a letter explaining the patient's dilemma is the starting point. rejection by the insurance can be appealed by the surgeon and also by the patient and her family. 

Breast size asymmetry

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sometimes the larger breast will have more ptosis ( sagging ). The larger side could need a mastopexy ( breast lift ) or even a reduction mammaplasty ( reducing breast size usually with a " lift ).  or an augmentation of the smaller side could be enough to gain reasonable symmetry.  To get insurance to cover any of these procedures will need to be preauthorized as medically necessary which may or may not be granted.  photographic documentation along with a letter explaining the patient's dilemma is the starting point. rejection by the insurance can be appealed by the surgeon and also by the patient and her family. 

Asymmetry and breast augmentation

Thank you for your question. Unfortunately this will be an uphill battle with any insurance company as they will not be sympathetic to your concerns emotional or physical. This is unfair but a reality. I would give you the advise or considering financing and finding a board certified plastic surgeon to help you with your surgery

Bruce Landon, MD
Tampa Plastic Surgeon
4.6 out of 5 stars 18 reviews

Asymmetry and breast augmentation

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Thank you for your question. Unfortunately this will be an uphill battle with any insurance company as they will not be sympathetic to your concerns emotional or physical. This is unfair but a reality. I would give you the advise or considering financing and finding a board certified plastic surgeon to help you with your surgery

Bruce Landon, MD
Tampa Plastic Surgeon

When will insurance pay for BA

Thank you for your question. Unfortunately insurance companies rarely pay for this type of procedure even for congenital abnormalities. With that said you should speak with your primary care doc and get their opinion. Good luck. 

DrMaz 

When will insurance pay for BA

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Thank you for your question. Unfortunately insurance companies rarely pay for this type of procedure even for congenital abnormalities. With that said you should speak with your primary care doc and get their opinion. Good luck. 

DrMaz 

When will health insurance cover a breast augmentation?

In general health insurance will not pay for a breast augmentation.   However, if you truly have a deformity of your breast, this may be considered a breast reconstruction which may be covered.    If you are not aware of what kind of coverage comes with your particular insurance policy, it would be best to contact your insurance company directly and ask them.  You can also request a list of plastic surgeons who are in network with your plan; a plastic surgeon in network with your insurance plan should be able to help you sort this out too.  Hope that is helpful -

When will health insurance cover a breast augmentation?

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In general health insurance will not pay for a breast augmentation.   However, if you truly have a deformity of your breast, this may be considered a breast reconstruction which may be covered.    If you are not aware of what kind of coverage comes with your particular insurance policy, it would be best to contact your insurance company directly and ask them.  You can also request a list of plastic surgeons who are in network with your plan; a plastic surgeon in network with your insurance plan should be able to help you sort this out too.  Hope that is helpful -

Cosmetic indication

Sorry to hear about the issues you are having with your breast proportions relative to the rest of your body. The good news is that breast augmentation can certainly significantly improve upon all the factors you mentioned.  Insurance companies do not find that this is medically necessary and will deny coverage for this. As stated, I would first begin your journey by seeking out a board certified plastic surgeon that performs many cosmetic breast procedures and obtain an in depth consultation in which certain breast measurement of you are taken and discussion about your specific "look" is entertained.

Best wishes,

Dr. Ravi Somayazula

Cosmetic indication

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Sorry to hear about the issues you are having with your breast proportions relative to the rest of your body. The good news is that breast augmentation can certainly significantly improve upon all the factors you mentioned.  Insurance companies do not find that this is medically necessary and will deny coverage for this. As stated, I would first begin your journey by seeking out a board certified plastic surgeon that performs many cosmetic breast procedures and obtain an in depth consultation in which certain breast measurement of you are taken and discussion about your specific "look" is entertained.

Best wishes,

Dr. Ravi Somayazula

Breast Augmentation

Sorry to hear of your struggles, it must be difficult.  However, there are ways to improve your breast appearance and symmetry.  First off, I doubt health insurance will cover this type of procedure, but we could always try.  The only breast surgeries they seem to cover are anything related to breast cancer and very large breast reductions.  The best way to start is seek a board certified plastic surgeon in order to have a proper physical examination in which then a good recommendation can be given.  Many offices, including myself, offer free consultations so you can start there.  General thoughts can be to either augment the small breast, reduce the large breast, or a little bit of both.  

Best of luck and hope this information helps!

- Dr. Roger Tsai

@DrRogerTsai

Breast Augmentation

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Sorry to hear of your struggles, it must be difficult.  However, there are ways to improve your breast appearance and symmetry.  First off, I doubt health insurance will cover this type of procedure, but we could always try.  The only breast surgeries they seem to cover are anything related to breast cancer and very large breast reductions.  The best way to start is seek a board certified plastic surgeon in order to have a proper physical examination in which then a good recommendation can be given.  Many offices, including myself, offer free consultations so you can start there.  General thoughts can be to either augment the small breast, reduce the large breast, or a little bit of both.  

Best of luck and hope this information helps!

- Dr. Roger Tsai

@DrRogerTsai

Different Breast Size

Thank you so much for your question and I am so sorry for the struggle that you are having with all of this. The good news is there are things that can be done. The best place for you to start is with a board certified plastic surgeon who does quite a bit of breast surgery. You may have to pay for a consultation as this is usually a cosmetic procedure. There are very few insurances that cover this kind of thing, but if you get into the right office and get an evaluation that surgeon may find that this is something they can try to see if insurance will cover. I know it seems unfair that insurance won't cover this but they usually have the general feeling that if there is no physical harm to your body requiring a procedure then this would be cosmetic in nature. They see it as physical change or improvement. Being that said, I would start with getting a consult with a well respected surgeon and they will then point you in the right direction. I would see as may doctors as it takes until you find one that you feel comfortable with and confident.

Different Breast Size

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you so much for your question and I am so sorry for the struggle that you are having with all of this. The good news is there are things that can be done. The best place for you to start is with a board certified plastic surgeon who does quite a bit of breast surgery. You may have to pay for a consultation as this is usually a cosmetic procedure. There are very few insurances that cover this kind of thing, but if you get into the right office and get an evaluation that surgeon may find that this is something they can try to see if insurance will cover. I know it seems unfair that insurance won't cover this but they usually have the general feeling that if there is no physical harm to your body requiring a procedure then this would be cosmetic in nature. They see it as physical change or improvement. Being that said, I would start with getting a consult with a well respected surgeon and they will then point you in the right direction. I would see as may doctors as it takes until you find one that you feel comfortable with and confident.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.