Health Insurance & Plastic Surgery...Will it be covered?

Question

I reside in PA and have what most would consider great healthcare provided by my parent's work. My benefits will run out in a few years, when I graduate college. I have large breasts, (34-d) and am planning to at some point in my life get a breast reduction because they are uncomfortable, especially with my small body/stature. Will my Blue Cross/Blue Shield PPO plan cover the cost of the breast reduction surgery?

Answer 1

When you call a plastic surgeon's office to inquire about cost, be certain to ask if each of these fees is included. Often the prices quoted are only the surgeon's fee, that makes up only 60%-80% of the total cost. It isn't until you see the plastic surgeon and receive your quote that you find out that the price quoted was significantly lower than the actual cost.
Arm Lift (Brachioplasty) $5000-6500
Blue Peel $500-700
Botox $200-400 per area
Breast Augmentation (saline) $5000-6500
Breast Augmentation(silicone) $6000-8000
Breast Lift $5000-6000
Chin or Cheek Implants $3000-4500
Collagen Injection $500-1500
Deep Chemical Peel $3500-5000
Dermabrasion $2000-4000
Eyelid Tuck (upper & lower) $4000-5500
Face Lift $7000-9000
Forehead Lift (Brow Lift) $3500-5000
Hair Removal (Laser) $300-800
Laser (Erbium) $2500-4000
Laser (CO2) $4000-5000
Lip Augmentation $600-2000
Liposuction (1 area) $2500-4500
Liposuction (3 areas) $5500-7000
Liposuction (5 areas) $8000-10,000
Medium Peel $1500-2500
Micro Peel $60-100
Nose Surgery $5000-6000
Pectoral Implants $6000-7000
Permanent Eyeliner $300-1000
Permanant Lip Liner $300-1000
Spider Vein Rx (Laser) $400-1000
Spider Vein Rx (Sclero) $200-500
Tattoo Removal (Laser) $300-800
Tummy Tuck $6000-8000

Contacting a plastic surgeon is probably the best idea for advice. These sites have a lot of other helpful information…
http://www.san-diego-plastic-surgery-cosmetic-surgery-doctors.us/cosmetic-surgery-san-diego-breast-surgery-article-3.htm
http://www.san-diego-dentist.us/
http://www.medical-research-study-directory.info/san-diego-medical-research-study.htm
http://hoodia-research.blogspot.com
http://www.acne-treatment-medicine-1.info

Answer 2

Cosmetic surgery is not covered by health insurance. The only time it is covered is if you are disfigured from an accident, or a doctor finds it necessary for your health purposes.

Even then the companies make you go through a big hassle with all the paper work, and they submit it to their companies legal staff. So I doubt it. But you can't lose anything by trying.

There is one route you can take. I know I also was extremely full breasted like you as a 13 year old. I was very subconscious of my self. It had a great psychological effect on me. I was very embarrassed. Maybe if you go to a psychiatrist and he finds that it is impeding your mental health you can fight it out with your insurance company.

Good luck to you. I know where your coming from.

Answer 3

~~There is no health insurance company that will pay for any type of cosmetic surgery unless it is causing a medical condition. If your doctor has objective proof the excess skin is causing damage in some way medically, then maybe, but it is next to impossible.~~

Answer 4

You need to find the "Insurance Guide Book." That has a complete list of procedures that the insurance will or will not cover. Try looking at your insurance's website. You might be able to find it there. I would also call a representative and double check. Even if the surgery is covered, you might have to see a specific surgeon or the company may not pay.

Answer 5

It really depends. Are you getting it done for cosmetic reasons, or does it cause any health problems? If it is purely cosmetic chances are it won't be covered. If you have chronic back pain or other such problems because of it, and it has not responded to other treatment, then there's a chance. But I still wouldn't count on it.
The best way to find out for sure is to call your insurance company. There should be an 800 number on your card for policy holder inquiries, and they should be able to tell you for sure.
Best of luck.

Answer 6

i'm not really sure about this but i watch those plastic surgery shows alot and most insurence companies do AND my aunt had this done about 3 years ago (we live in Pittsburgh).. it would be a whole other story if you wanted to make your boobs bigger though because thats a cosmetic surgery. just tell them that your breasts are the source of your back pain or whatever is bothering you and that instead of years of going to a chiropracter, getting them reduced would instantly fix the problem. most likely it'll be covered because its not just cosmetic its for you health also

Answer 7

Insurance companies have different plans, so you'd have to just send in the information and see what they will do. If they do deny you, appeal like crazy. BCBS does cover it with some people that I know (from the site below), but it depends on the person.

http://www.breasthealthonline.com
Reduction Feb 2006

Answer 8

Insurance will only pay for plastic surgery if your breasts are causing you health problems. If you can convice a doctor of that, he will be better able to convince an insurance company that it was deemed medically necessary.

Answer 9

1

Answer 10

get a free consultation with a Plastic Surgeon
the Md's biller will know or be able to find out for you after the diagnosis/ exam