What are medical reasons that health insurance would cover a breast reduction?

Question

I want to have my breasts reduced but I am not certain what would be a medically acceptable reason that is covered by insurance. I am also wondering if you have to be a certain size??

Answer 1

You do not need to be a certain size, but insurance companies will approve surgery if a certain amount is removed. For example, my company said they would cover it if 600 total was removed. I ended up having over 2000 total removed so I was covered. MY insurance co paid 100%. Some will only pay 80%, or 75%, etc.

http://www.breasthealthonline.com has TONS of information for you. Register and check out their FAQ section (as well as insurance section and support section)!!

Answer 2

Most insurance will cover it but it has to be deemed medically necessary. They also require that the reduction be a certain percentage of the existing size. Which is also considered a medical necesity within itself. You need to see a good reputable plastic surgeon for this surgery because if it is done wrong it could prevent you from being able to breast feed in the future. Go to pastic surgeon that deals with a lot of breast cancer patients as well. Other forms of medical necessity is back pain, neck pain, shoulder pain a large amount of weight loss. I have known very many teenagers that are having this done because they are so large. The younger the better too.

Answer 3

A breast reduction could be covered by medical insurance as long as it is deemed medically necessary by the surgeon preforming the reduction & as long as the services have been approved by your medical insurance. ( trust me, I know, I work for an insurance company). The best thing for you to do is the check w/your insurance company & make sure this is a covered benefits & to check with the provider & make sure that the procedure is considered medically necessary. Medically necessary means that it could cause other major health problems (like back pain) or that it is life threatening. Only your provider or the surgeon can justify medical necessity

Answer 4

You would probably need to find a doctor that would put in a recommendation for breast reduction based on CHRONIC back, shoulder and neck pain, to the point of being debilitating....and even then (depending on the HMO) it could be iffy.

Answer 5

Breast Reduction surgery is very safe nowadays. My cousin got her breast reduction, tummy tuck and facelift surgery in India by the company called Forerunners Healthcare .The Price for the surgery she paid in India was very less. She paid 30% of the cost she was quoted in America.

Forerunners Healthcare is very famous in India. They arrange cosmetic and plastic surgery for foreigners in India. I read a lot about them in the Newspapers and about their patient stories. They arrange financing for USA, Canadian, UK and other international patients who plan to have surgery abroad for low price, as the breast reduction, tummy tuck, facelift and other cosmetic surgery is not covered by insurance. They also have photos pasted of their International patients. You can checkout their website. There are huge cost savings. As a doctor I personally believe that surgery can be easily handled in India, as the quality of healthcare available In India is simply best in the world. The surgeons are USA/UK trained and facilities are 5 star.

http://www.forerunnershealthcare.com
Hope this helps.