I am 5'7" and last weighed at 210lbs, yes I know I am over weight. My bust is 40 H. I have been working out at my apartment's gym for a few weeks now. I have lost some fat and gained some muscle, and after losing some weight I gained it back without gaining the fat back (so in other words it is muscle) my natural waist is measured (this morning actually) at 34" and my bust is measured at 48", but all my doctor is concerned about is my weight. not my true body fat percentage. Any tips on how I could get my insurance approve my breast reduction?
July 20, 2020
Answer: Do you have any tips to get insurance to approve my breast reduction surgery? In Australia, this procedure is often deemed medically necessary, and therefore there is an associated Medicare item number. Therefore, private insurance rebates will apply, assisting with the overall costs. The main contribution will be towards the hospital fee. However, the total price you pay even with insurance will depend on the specifics of the surgery. This is because we cater each operation to the patient.
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July 20, 2020
Answer: Do you have any tips to get insurance to approve my breast reduction surgery? In Australia, this procedure is often deemed medically necessary, and therefore there is an associated Medicare item number. Therefore, private insurance rebates will apply, assisting with the overall costs. The main contribution will be towards the hospital fee. However, the total price you pay even with insurance will depend on the specifics of the surgery. This is because we cater each operation to the patient.
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July 25, 2018
Answer: How to get breast reduction covered by insurance Great question and I mimic what Dr. Hammoudeh said. The key is to document (have receipts or photos) every medication or powder/cream you may have purchased if you have rashes under your breasts. Document or obtain any office notes from your PCP indicating issues with shoulder grooving, back and neck pain. Some insurance carriers also want proof that you tried dieting and exercise to reduce the weight of your breasts for a certain period of time (ie. 3-6 months). All this and they will still require a letter of necessity from your doctors and photographs. Not to mention they require a weight of tissue removed during surgery which may not be either feasible or what you inevitably desire as your overall size. Given that there are so many moving parts, consulting with a plastic surgeon is best to determine your goals, expectations and likelihood that your reduction will be covered for insurance. Oh, and hearing back on whether the insurance company covers the procedure could take several weeks to a few months, so timing your surgery and consultation around your schedule is key. Hope that helps!
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July 25, 2018
Answer: How to get breast reduction covered by insurance Great question and I mimic what Dr. Hammoudeh said. The key is to document (have receipts or photos) every medication or powder/cream you may have purchased if you have rashes under your breasts. Document or obtain any office notes from your PCP indicating issues with shoulder grooving, back and neck pain. Some insurance carriers also want proof that you tried dieting and exercise to reduce the weight of your breasts for a certain period of time (ie. 3-6 months). All this and they will still require a letter of necessity from your doctors and photographs. Not to mention they require a weight of tissue removed during surgery which may not be either feasible or what you inevitably desire as your overall size. Given that there are so many moving parts, consulting with a plastic surgeon is best to determine your goals, expectations and likelihood that your reduction will be covered for insurance. Oh, and hearing back on whether the insurance company covers the procedure could take several weeks to a few months, so timing your surgery and consultation around your schedule is key. Hope that helps!
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June 28, 2018
Answer: Getting a breast reduction covered by insurance Hi and thanks for your question. Every insurance plan has its own specific criteria for what they consider medically necessary in regards to a breast reduction, despite what your doctor’s opinion may be. It’s the patient’s responsibility to be proactive and contact their own plan in advance so that they can be familiar with these criteria and provide their doctor with the relevant information (for example, if you’ve been treated by a physical therapist, or if you been prescribed medication for rashes). Don’t expect your doctor to know the details of what your specific individual plan considers medical necessary, your doctor can provide their medical opinion but ultimately the insurance company decides if they agree — every plan is different and has its own rules. If you want to get your insurance involved stay ahead of the game and find out their specific requirements in advance by contacting them yourself. That way there’s no surprises.A visit to a plastic surgeon's office will help you to understand if you're a candidate for the procedure, and what aesthetic outcomes are realistic in your particular case. In order to get a qualified, ethical, and expert opinion on your surgical options and expectations, always schedule an in-person office consultation with a plastic surgeon certified by the American Board of Plastic Surgery.
Helpful
June 28, 2018
Answer: Getting a breast reduction covered by insurance Hi and thanks for your question. Every insurance plan has its own specific criteria for what they consider medically necessary in regards to a breast reduction, despite what your doctor’s opinion may be. It’s the patient’s responsibility to be proactive and contact their own plan in advance so that they can be familiar with these criteria and provide their doctor with the relevant information (for example, if you’ve been treated by a physical therapist, or if you been prescribed medication for rashes). Don’t expect your doctor to know the details of what your specific individual plan considers medical necessary, your doctor can provide their medical opinion but ultimately the insurance company decides if they agree — every plan is different and has its own rules. If you want to get your insurance involved stay ahead of the game and find out their specific requirements in advance by contacting them yourself. That way there’s no surprises.A visit to a plastic surgeon's office will help you to understand if you're a candidate for the procedure, and what aesthetic outcomes are realistic in your particular case. In order to get a qualified, ethical, and expert opinion on your surgical options and expectations, always schedule an in-person office consultation with a plastic surgeon certified by the American Board of Plastic Surgery.
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