Will My Health Insurance Cover a Breast Reduction?

Contact your health insurance company to determine if they cover your breast reduction; many have different guidelines, so yours may not cover the procedure. Most health insurance plans don't cover breast reduction since it requires months of preparation and secondary consultations.

· 2 min read
Will My Health Insurance Cover a Breast Reduction?

If you're wondering, will your health insurance cover a breast reduction? There are several factors to consider. For example, it depends on whether the procedure is medically necessary or cosmetic. In addition, you may need to undergo secondary consultations with other healthcare providers and therapy. Your insurer might also require 3-6 months of preparation for the procedure. After this, you should check with your insurance provider to determine if you have the appropriate coverage.

Medically necessary

When determining whether a breast reduction is medically necessary, insurance companies use different criteria to determine coverage. Traditionally, insurance companies will consider the amount of tissue removed from each breast. However, many insurance companies are considering a patient's symptoms, such as back pain, neck pain, or a skin rash. The specific criteria that your insurance company will accept may vary by plan and carrier. A plastic surgeon in Mountain View, CA, can explain the process to you in more detail.

Cosmetic

If you have enlarged breasts, you may be wondering if cosmetic breast reduction is covered by health insurance. Although most women do not consider this surgery to be "cosmetic," some women are concerned about the size of their chests and are willing to undergo the procedure to improve their appearance. While some women may feel self-conscious and embarrassed by the attention they receive, others may suffer from negative body image issues. Regardless of your reasons, cosmetic breast reduction may help you gain self-confidence and relieve your emotional distress. Unfortunately, because breast reduction is considered purely cosmetic, it is not covered by health insurance.

Medicare

If you have Medicare, you probably wonder whether or not Medicare will pay for your breast reduction. In many cases, the answer is yes. Medicare covers the surgery, but you'll have to pay a deductible and co-insurance. Medicare Part A pays 100% of the procedure's costs, while Medicaid covers the rest. However, you can't count on Medicare to cover the full cost of your breast reduction. You should also be aware of the co-insurance and deductibles you'll need to pay for breast reduction.

Pre-authorization

If you consider breast reduction surgery, obtaining pre-authorization from your health insurer is important. Most insurance plans do not cover the procedure unless it is pre-authorized. You should contact your health insurance provider to learn what information is needed, including the requirements and acceptable forms of proof. In addition to a medical necessity for the procedure, insurance companies require that you have tried non-surgical treatments such as weight loss, physical therapy, and musculoskeletal treatments, including braces. In the case of severe rashes, you may have to show proof of a skin infection.

Before and after photos

You should see before and after photos of breast reduction procedures from a good reputable surgeon. In addition to a high standard of patient care, a reputable surgeon should have a lot of photos to show potential patients. A good doctor should have a lot of real results. Check out their galleries on the website to see the results of other patients. Many of these photographs are from actual patients. They are protected by copyright, and you should not link to them or copy them without permission.

Recovery

Several weeks after your breast reduction, you may feel better. It would help if you were careful to avoid sudden movements, such as bending, stooping, or lifting anything heavy. Your body is still healing, so you should closely follow the surgeon's postoperative care instructions. After a couple of weeks, you can resume your regular exercise routine. Wear your surgical bra as much as possible to encourage proper healing. Recovery may take longer in people with poor circulation.