Regence UMP Washington. 4 medical professionals recommend breast reduction for me. Yet, I don't fit the Schnur Sliding Scale?

Question

I have three cervical herniated discs, C3-7. Years of conservative therapies; chiro, PT, massage, acupunct, office ergonomics, etc. I still have considerable pain daily. My PCP/Internist, Neuromuscular & Spinal Specialist/MD, PT, and DO all suggest and support breast reduction. My problem is large breasts with not allot of mass, along with my weight. Regence has denied my breast reduction. I hit all the the criteria EXCEPT Schnur scale. I need solid arguments for to disregard the Schnur scale.

Gerald Minniti, MD, FACS · Answer

Hello,Even if you hit the Schnur scale, your company might still deny you.  Breast reduction coverage is fading away. Too much abuse and flimsy data make it more of a cosmetic procedure. My recommendation is finding a surgeon that does this surgery really well; chances are he doesn't take insurance anyway.  If you don't have the money, then finance it through a number of good companies. Best of luck!

Curtis Wong, MD · Answer

your breasts are not that heavy... and subsequently would not be anticipated to help you much with a reduction.  And the Schnur scale is pretty lenient as many companies no longer accept it, instead placing higher weight resections to have them cover the procedure.  If you're convinced your breasts are contributing, pursue this cosmetically and you should ask around and take the best price you can get, presuming the surgeons are all equal in reputation and outcomes.

Richard P. Rand, MD, FACS (retired) · Answer

You are not alone as we see so many patients who, in the past, would get covered for breast reduction. Medical insurance is leaving breast reduction as a covered benefit, making it extremely hard to get covered despite all the premiums you have paid. What I see is many patients saving up and paying out of pocket to get this done.

Sherwood Baxt, MD (retired) · Answer

sounds like this could be a good scenario for the Scarless, or liposuction only procedure.  This can be performed as an outpatient under light sedation and is often dramatically less expensive than a traditional reduction. It sounds like your problem is more functional than aesthetic. Find a board-certified plastic surgeon in your area who specializes in this particular variation of the operation And it's probably worth looking into. Good luck.

Regence UMP Washington. 4 medical professionals recommend breast reduction for me. Yet, I don't fit the Schnur Sliding Scale?

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