Your plastic surgeon will help you. Some insurance companies won't cover breast reduction unless the surgeon plans to remove at least 500 grams (more than one pound) of breast tissue on both sides, even though studies have shown that the amount of tissue removed is unrelated to relief of symptoms.


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The specific factors that matter for you will vary depending on both your insurance company and your individual policy.

Do insurance cover breast reduction surgery. The good news is that your health insurance provider may cover breast reduction surgery when there is a medical justification. Breast reduction surgery will generally be construed as a cosmetic procedure unless the patient can prove that they have an underlying health condition that can only be remediated by. When i started considering breast reduction surgery, my insurance provider took 6 weeks to respond, and unfortunately they did not cover surgery as part of my plan period, regardless of the medical necessity.

Patients will typically have documented evidence of neck/back and shoulder pain as well as rashes and bra strap grooving attributable to the increased breast weight. Each has different criteria , many insist on a course of physical therapy first, they also require additional documentation and evaluation of your neck and back pain complaints as they may be due to other causes. 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.

Breast reduction and health insurance. Breast reduction is considered a therapeutic procedure with specific health benefits and is covered by most insurance carriers when specific criteria are met. These issues are very real and do justify effective treatment through reduction.

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Below are some of the most common reasons for medically necessary breast reduction procedures: So the good news is that in some or most cases breast reduction surgery may be covered by your health insurance. You may well be a candidate for breast reduction surgery from what you describe.

Posted may 15, 2018 by jacob bloom, m.d. Breast reduction cosmetic surgery (reduction mammaplasty) is sometimes performed to alleviate or improve medical symptoms of pain and discomfort caused by oversized breasts. Every health insurance provider may.

Does aetna health insurance cover breast reduction surgery? Whether or not insurance companies will cover your surgery varies greatly. Large breasts that could be reduced by at least 3 cups sizes or more (500g or more)

Some insurance providers take as little as a few days to get back, others take a couple of months even. Breast reduction is considered to be a cosmetic procedure (which is not usually covered by insurance) until the patient can demonstrate a number of associated health issues and attempted treatments. A pain management specialist can help you support your coverage claim with a large amount of medical evidence.

Patients just need to take a few steps on their own to make sure their health insurance plan covers their breast reduction surgery. It is universally believed by patients that if a surgery is considered reconstructive, it is medically indicated and covered by health insurance. Common problems women seek to alleviate with a breast reduction.

In fact, around 75% of patients who have a consultation for the procedure may qualify for insurance coverage. If ultimately you cannot get health insurance to cover this for you many surgeons offer a cosmetic option for breast reduction and even help to set up financing. Breast reduction is one of the most popular procedures that plastic surgeons do, and typically breast reduction patients are very happy with their results.it is one of the few plastic surgery procedures that is covered by insurance.

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Conversely, many patients believe if a procedure is considered cosmetic, it is not a medically indicated and covered procedure. However, there is no guarantee that insurance will cover the costs of breast reduction in every case. Even in this situation some insurance companies simply do not cover breast reduction as part of their plan.

If approved, your costs with insurance could include deductibles, co. Answered by the institute of aesthetic surgery (view profile) insurance coverage of breast reduction is contingent on establishing a case for medical necessity. This is due to the medical need to reduce breast volume and weight.

However, patients must meet a number of criteria before their insurance will pay for this surgery. If your physician certifies that the procedure is medically necessary, medicare may help cover the costs of your. Whether an insurance company will cover breast reduction surgery is a very common question for many patients.

Each insurance company has its own set of coverage criteria and prior. While all of these symptoms might be present in a woman with large breasts, reduction mammaplasty may not immediately be covered by your health insurance. Insurance requirements do vary by company and insurance plans, but usually, if a woman is experiencing the following their insurance might cover this procedure:

This is likely to be covered in your delineation of benefits. However, this doesn’t mean that it won’t be covered. Typically, health insurance companies will only cover the cost of breast reduction surgery if an individual’s enlarged breasts are causing health issues.

Depending on the details of your breast reduction, your insurance may cover part or all of your surgery cost. The best way to obtain insurance coverage for breast reduction surgery involves some “hoops” to jump through. Clearly, having your healthcare plan cover the expense is the preferred option.

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Male and female patients who are seeking breast reduction must show that they have tried other medical treatments and sought prior consultations regarding. The cost of breast reduction surgery without insurance is about $5,600 before factoring in facility fees, anesthesia, and related expenses.


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