Will Anthem Blue Cross Blue Shield cover a breast reduction?

Question

I am 29 years old, I wear a 34G. I'm 5'3" and 139lbs with a waist size of 29 inches. I've struggled with shoulder and neck pain, tension, tension headaches, poor posture, deep grooves in my shoulders for years now and have been nothing less than a DD since I was 15 (i weighed about 125 then). I've tried exercise and weight loss and i even breast fed my son until he was a year and a half and nothing has helped! I want to be a size B

Urmen Desai, MD, MPH, FACS · Answer

I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon
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Scott C. Lindsay, DO · Answer

Hello and thank you for your question
Contact your insurance company to find out if this surgery is a covered benefit for you and what the criteria is. Schedule a consult with a board certified plastic surgeon to discuss your options. Best wishes!

Andres Taleisnik, MD · Answer

The criteria for insurance coverage of breast reductions varies depending on the insurance company, and on the specific insurance plans within that company. Generally, the acceptance of coverage depends on a combination of symptoms, and removal of a certain amount of weight that is determined based on the weight of the patient. If enough breast weight is removed, then it is deemed that the surgery is being performed for a legitimate medical purpose, since that removed weight can improve symptoms. If very little breast tissue is removed, then the surgery is really more of a lift. From your descriptions, it seems that you would likely qualify for coverage. Good luck!

Eric Wright, MD · Answer

Hi, based upon your symptoms you have listed as well as your size, it sounds appropriate to be evaluated for a breast reduction.  Yes, insurance covers breast reductions.  Once you are evaluated by a board certified plastic surgeon, your medical history and exam will be sent to the insurance company for approval before your surgery.  Certain criteria have to be met before insurance will approve a surgery.  It also can be based upon your specific insurance plan.   Good luck, you will feel much better after your reduction.Dr. Wright

Daniel Barrett, MD · Answer

Dear gwendolynd89,based on your description, it sounds like you might be a good candidate for a breast reduction surgery. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Will Anthem Blue Cross Blue Shield cover a breast reduction?

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Will Anthem Blue Cross Blue Shield cover a breast reduction?

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