I'm 19 years old and my bra size is 40G. Would Horizon, NJ health care cover my breast reduction?

Question

I'm a college student i have free insurance and im wondering if horizon nj will cover my breast reduction. I have bad back pains/spine pain and alway feel like i need to crack my back. If so whats the smallest size a 40G can go?

Ted Eisenberg, DO, FACOS, FAACS · Answer

Health insurance often covers breast reduction surgery because of the medical problems associated with larger breasts. You can call your company before you schedule an appointment to see if coverage will be considered. If they might cover you, you’ll need to gather documentation to support your claim – a medical letter from your primary physician, X-ray reports, a list of medications, etc. Bring these to your breast reduction consultation. Your surgeon will also need to write a letter and take two photographs – a front and side view of your breasts (without your face). The whole package is sent to the medical director of your insurance company, who
reviews the case and lets you know if your request is approved or denied.

Tom J. Pousti, MD · Answer

Thank you for the question. Based on your limited description, you sound like you may be an excellent candidate for  breast reduction surgery; of course, much more information is necessary to provide you with definitive advice.

Best to check directly with your insurance company to see whether breast reduction surgery is a “covered” benefit with your specific policy. Then, given that every insurance company has different “criteria”, best to identify exactly what your specific insurance company considers criteria for approval. Generally, the more documentation you have (for example, from your primary care doctor, physical therapist, chiropractor etc.) the better when it comes to obtaining insurance “authorization” for the procedure.  
This documentation and letter/pictures from your plastic surgeon will help you obtain authorization. Keep in mind, as you work towards your goals breast reduction surgery is one of the most patient pleasing operations we perform. Also, prepare to be persistent when dealing with health insurance companies.Once you have chosen your plastic surgeon carefully, it will be important for you to communicate her goals carefully as well. In my practice, I asked patients to use as many “visual aids”, such as goal photographs, during the communication process. Avoid the use of subjective terms; for example, "B or C cup” and/or “ as small as possible"… these terms can be confusing, since they may mean different things to different people. Once you have communicated your goals, your chosen plastic surgeon will be able to  provide you with a more precise plan, including specific technique to be utilized.

I hope this, and the attached link (dedicated to breast reduction surgery concerns), helps. Best wishes.

Steven Wallach, MD · Answer

Many insurance companies will cover breast reductions. Best to check with your insurance company to determine what the criteria are.

I'm 19 years old and my bra size is 40G. Would Horizon, NJ health care cover my breast reduction?

Answers (3)

Recommended reading

Everything you need to know about Breast Reduction

Our mission is to create a world where every investment in modern beauty is Worth It.

I'm 19 years old and my bra size is 40G. Would Horizon, NJ health care cover my breast reduction?

Answers (3)

Browse related questions

Recommended reading

Everything you need to know about Breast Reduction

Our mission is to create a world where every investment in modern beauty is Worth It.