How Much Does United Healthcare Require You to Remove for Breast Reduction?

Im 5'6 and 175.  i am a d but if its 500c that will take me to a b and it looks awful small

Doctor Answers 5

How Much Does United Healthcare Require You to Remove for Breast Reduction?

Besides being VERY difficult to obtain health insurance pre authorization these days, especially from UHC. Also the dollar reimbursement rates have "dropped" so very low that the last $'s I have received from UHC was less than $800 (total). The risks for the pay are getting so little it might be better to offer free surgery than waiting 3 to 6 months to be reimbursed this small amount for 3 hours of surgery and many before and after visits. In fact I offer each month one no surgeons fee cosmetic surgery in my office, especially in cases like this. Just my opinions and thoughts. 

Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Gram weight resection for breast reduction

Honestly, if you have United Healthcare, a reduction will not be approved unless you meet the criteria. If you are a true D cup, not a DD, then you may be a borderline case and could well be denied coverage. The minimum in New York is 500 cc. If you are not comfortable with that much reduction, then the operation would be a breast lift which is not covered by health insurance.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 41 reviews

Breast Reduction and Insurance Coverage?

Congratulations on your decision to proceed with breast reduction surgery; this operation tends to be one of the most patient pleasing operations we perform.

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.

There is no way that online consultants can be of much help to you when it comes to predicting a specific insurance companies behavior or predicting exactly what how  much  tissue should be removed during your breast reduction procedure. These issues are best addressed during the consultation process with your chosen plastic surgeon consultants.

Before undergoing the breast reduction procedure it is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup”   etc mean different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also

Seek consultation with board-certified plastic surgeons who can demonstrate significant experience helping patients in your situation. Only through this process will you be able to receive the precise information you need to make well-informed decisions.  

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

United healthcare and breast reduction

Each insurance company will require different things first to get it approved and then may require a specific volume of tissue to remove. It all depends. Best to ask the insurance compnay directly.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Insurance companies have different requirements for coverage of breast reduction.

Your specific question cannot be answered. When you consult with your plastic surgeon his office will determine the requirements for breast reduction in your particular case.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.