Q&A

Does insurance cover medically necessary breast reduction?

Does insurance cover medically necessary breast reduction?

Most insurance carriers will offer breast reduction covered by insurance as long as it meets certain requirements to be deemed “medically necessary”. Traditionally the main point an insurance company considers is the amount of tissue to be removed from each breast.

How can I convince my insurance to cover a breast reduction?

In most cases, insurers require the surgeon write a letter describing the patient’s symptoms and physical findings, estimating the breast weight to be removed, and requesting coverage. This should be done prior to scheduling surgery because the insurer may not be obligated to pay if surgery was not preauthorized.

What makes a breast reduction medically necessary?

The goal of medically necessary breast reduction surgery is to relieve symptoms of pain and disability. If an insufficient amount of breast tissue is removed, the surgery is less likely to be successful in relieving pain and any related symptoms from excessive breast weight (e.g., excoriations, rash).

Does breast reduction include a lift?

You’ll get a breast lift, too The procedure is actually a twofer: Your surgeon will remove excess tissue and skin to make your breasts smaller, and then move the nipples up in position to give them a lift.

Is a lift included in a breast reduction?

Breast reduction is performed on more than 100,000 patients annually and focuses on making the breasts smaller. The tissues removed during this procedure include milk glands and fat for a true reduction in size. A breast lift, on the other hand, does not remove fat or tissue.

Is 60 too old for breast reduction?

Too old for Breast Reduction? Absolutely not, as long as you are in good health and have no problems that would interfere with healing or anesthesia. I have done a Breast Reduction on a woman at least 15 years older than you, and she was one of the happiest patients I have ever had.

How much does a DD cup breast weigh?

between 15 and 23 pounds
For many women, this has been a burdensome trend. A pair of D-cup breasts weighs between 15 and 23 pounds — the equivalent of carrying around two small turkeys. The larger the breasts, the more they move and the greater the discomfort.

Is 65 too old to get a breast reduction?

Conclusions: Age is not a contraindication for reduction mammaplasty. Breast reduction surgery is a safe procedure in elderly women and leads to even higher patient satisfaction.

Is 50 too old to have breast reduction?

Female breast reduction patients over the age of 50 may be at a higher risk of complications, especially infections, when compared to younger women, according to the latest issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons.

When is breast reduction surgery covered by insurance?

Breast reduction is usually covered by insurance when the surgery is performed as part of a medically mandated procedure to treat neck, back, or shoulder pain or other problems related to the spine.

How is breast reduction surgery done for women?

Breast reduction surgery removes excess breast tissue and reshapes the contour of the breasts so that they are smaller and perkier. I commonly use a minimal incision technique (Le Jour), eliminating the need for large scars while providing a pleasing breast contour and shape that is proportionate to the patient’s body.

How to reduce the size of a droopy breast?

To perk up a drooping breast, your surgeon will remove excess skin, reposition the nipple, and redrape and tighten the remaining skin to support the breast. The areola may also be reduced in size. A mastopexy (breast lift) raises droopy breasts from one to several inches and excess skin is removed.

Is the breast reduction surgery covered by health insurance?

The answer to “is breast reduction surgery covered by health insurance?” can be very complicated and involve many variables. It is universally believed by patients that if a surgery is considered reconstructive, it is medically indicated and covered by health insurance.

Is it possible to get a breast reduction?

Based on your description you may be a good candidate for breast reduction surgery; it is 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.

When is a 36DD too small to get a breast reduction?

If your breasts measure 36DD and you feel they are overwhelming for your body, or you have noticed back pain and other problems associated with macromastia (large breasts), then you could be a good candidate for breast reduction surgery.

What is the medical term for breast reduction?

This procedure, also known as reduction mammaplasty, is indicated for the treatment of symptomatic macromastia (large breasts). The commonly reported symptoms related to macromastia are neck, shoulder and back pain caused by the weight of overly large breasts upon the musculoskeletal system.