I have Federal Blue Cross Blue Shield - I want to go as small as possible on size.

With today's insurance plans under the ACA, less and less insurance companies cover breast reduction surgery despite that you may have symptoms such as painful bra strap grooving, neck, shoulder and back pain overly large breasts. However, I suggest contacting your insurance company and asking exactly what is and isn't covered in regards to treating macromastia with a breast reduction.  If they do offer coverage then ask for a list of in network providers whom you can then contact to set up an appointment and consultation with to address your concerns. 

Thank you for your question. It sounds like you may be an excellent candidate for a Breast Reduction procedure. Whether your insurance will cover it or not has to do with the provisions of your plan, and whether or not it is even a covered benefit. If you call the Member phone# on the back of your insurance card, it should be fairly easy to find out if the procedure is covered, as well as what medical record documentation is required. Please be certain to schedule a consultation with a board-certified plastic surgeon. 

Sounds like you have been suffering for quite some time with your large breasts. All plans are different but I would guess you would be able to have insurance cover your surgery based on your symptoms