I am currently considering a breast reduction. I am 5'9", roughly 215 pounds, wearing a 38DDD bra. In the last couple of years, I've lost 40 lbs and went from a G to a DDD. I currently deal with migraine from neck strain and rashes under my breasts. What does Blue Shield of California require in order to cover this procedure? Will taking enough tissue for me to go from a DDD to roughly a D be enough tissue for them to cover this?
August 29, 2018
Answer: Blue Shield of California Coverage Breast reduction Blue Cross Blue Shield has different requirement depending on state and insurance plan. The process to receive insurance reimbursement for the breast reduction procedure can be quite frustrating. Moreover, different insurance companies generally have different requirements. There are a series of questions that must be answered prior to beginning the insurance process.1. Have you experienced persistent symptoms in at least two of the anatomical body areas below, affecting daily activities for at least one year: Pain in upper back Pain in neck Pain in shoulders Headaches Painful kyphosis documented by X-rays Pain / discomfort / ulceration from bra straps cutting into shoulders; 2. Have you had a mammogram within the last year? 3. Have you tried any of the following therapies for 3 months or more? Supportive devices (e.g., proper bra support, wide bra straps) Analgesic / non-steroidal anti-inflammatory drugs (NSAIDs) interventions Physical therapy / exercises / posturing maneuvers 4. Have you seen a physician for the symptoms you have experienced? When? Your physician must also be able to document symptoms such as back and neck pain, headaches, also needs to ensure that the estimated reduction is consistent with the insurance company’s requirements for your BMI.
Helpful 1 person found this helpful
August 29, 2018
Answer: Blue Shield of California Coverage Breast reduction Blue Cross Blue Shield has different requirement depending on state and insurance plan. The process to receive insurance reimbursement for the breast reduction procedure can be quite frustrating. Moreover, different insurance companies generally have different requirements. There are a series of questions that must be answered prior to beginning the insurance process.1. Have you experienced persistent symptoms in at least two of the anatomical body areas below, affecting daily activities for at least one year: Pain in upper back Pain in neck Pain in shoulders Headaches Painful kyphosis documented by X-rays Pain / discomfort / ulceration from bra straps cutting into shoulders; 2. Have you had a mammogram within the last year? 3. Have you tried any of the following therapies for 3 months or more? Supportive devices (e.g., proper bra support, wide bra straps) Analgesic / non-steroidal anti-inflammatory drugs (NSAIDs) interventions Physical therapy / exercises / posturing maneuvers 4. Have you seen a physician for the symptoms you have experienced? When? Your physician must also be able to document symptoms such as back and neck pain, headaches, also needs to ensure that the estimated reduction is consistent with the insurance company’s requirements for your BMI.
Helpful 1 person found this helpful
September 26, 2014
Answer: Insurance coverage for breast reduction Not only does each insurance company have different policies, but each policy from the same company can be different. You will need to see a board certified plastic surgeon who can examine you and then get authorization from your insurance company. Typically it takes 4-6 weeks after submission of the information for the insurance company to decide. Good luck to you; it sounds like you could really benefit from this surgery.
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September 26, 2014
Answer: Insurance coverage for breast reduction Not only does each insurance company have different policies, but each policy from the same company can be different. You will need to see a board certified plastic surgeon who can examine you and then get authorization from your insurance company. Typically it takes 4-6 weeks after submission of the information for the insurance company to decide. Good luck to you; it sounds like you could really benefit from this surgery.
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