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    Old 02-16-2009, 06:06 PM   #1
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    clarona88pl HB User
    breast reduction

    what insurance will pay for breast reduction

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    Old 02-22-2009, 11:11 AM   #2
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    Re: breast reduction

    It all depends on the exact insurance policy under which you are covered. Every insurance company sells thousands of different plans - all with different benefits. So get a copy of the exact plan under which you are covered and pay special attention to the sections on exlusions and limitations.

    If Breast Reduction is not listed as an exclusion you just need to get the support from your physician that a breast reduction is medically necessary and then get consultations with a few plastic surgeons. Also be sure any plastic surgeon you see is comfortable advocating for you with the insurance company. Both your primary care and plastic surgeon must emphasize the medical necessity of the breast reduction so be prepared to fill them in on all the medical symptoms you have that lead you to believe a breast reduction is necessary.

    If Breast Reduction is listed as an exclusion under your insurance plan you can still seek to have it covered - but it will be an uphill battle and you'll have to be prepared to appeal any denial and work with your physicians or other practitioners (i.e. physical therapy) to have them advocate for the medical necessity of the procedure.

    If an insurance company believes the procedure is purely cosmetic they will not cover it. They must see the medical necessity.
    Rt thumb fusion '13. R&L thumb arthroplasty '12 ; RT TKR & Bilat CTS' 11. Fusions: L5-S1('87), L4-S1('93), C5-C7('06), L3-S1('10), C4-C5('13). C5-C7 foraminotomy '08

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