Will Tricare Cover Me for a Breast Reduction? (photo) (photo)

Question

I am 5'3 or 5'4, 176 pounds and I ware a 38ddd and 36G (depending on the brand of the bra). I am always having issues with my health because of my breast. Example: When I lay down flat on my back it's very hard to breath. Also they hurt when I don't ware a bra because of the constant sagging, which causes me to slouch over. I have bruises from my bra's, dents in my shoulders because the weight and sagging of my breast.I have severe back, shoulder and neck pains. I really can't take it anymore.

Tom J. Pousti, MD · Answer

Based on your description you may be a good candidate for breast reduction surgery.

	
	The best way to obtain insurance coverage for breast reduction surgery involves some “hoops” to jump through. 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.

	Make sure you're  working with a well-trained/experienced board-certified plastic surgeon.
	Good luck!

Steven Wallach, MD · Answer

At least based upon the photos and your history that you describe, you are a good candidate for a breast reduction. A full medical history and exam in person would be essential. As for your insurance company you should check with them regarding their criteria for approval.

Darryl J. Blinski, MD · Answer

From your photos and medical history you should be covered. But in each insurance company there are differing plans. Best to check with Tricare patient advocate to find out the steps in obtain insurance coverage for great reduction surgery.

John Whitt, MD (retired) · Answer

You certainly appear to be a good candidate for a breast reduction, assuming that you are in good general health. I don't think you should have a problem with Tricare coverage. Obtain a consultation with a BC plastic surgeon who can communicate with Tricare for you.

Will Tricare Cover Me for a Breast Reduction? (photo) (photo)

Answers (4)