Will Insurance Cover Breast Reduction

There is such a thing as medically necessary breast reduction. 172019 Not too long ago breast reduction surgery was not covered by insurance at all.

Sample Breast Reduction Letter Medical Necessity

Having large breasts can be the cause neck and upper back pain.

Will insurance cover breast reduction. Insurance companies do cover breast reduction surgery but each has their own criteria for authorization. Will Health Insurance Cover My Breast Reduction Many women are tired of dealing with their large heavy breasts. As long as your insurance company receives all of the medical necessity and pre operative information regarding your case they will likely approve the procedure.

Many times those who have significantly large breasts experience pain in the back neck shoulders and along the curvature of the spine. It required an act of Congress for having large heavy breasts to be acknowledged as a cause of multiple medical conditions including. The size of the planned reduction will be taken into account as well as symptoms including back neck or shoulder pain spine problems skin rashes or infections and nerve damage.

6302020 Medicare will cover breast reduction when its medically necessary. Many women suffer from chronic rashes beneath their breasts especially in the summer months. Some will though depending if there are clauses allowing for a doctors specific diagnosisprognosis that determines.

Many women wonder if breast reduction is covered under their insurance plan. Breast Reduction through Insurance Thank you for your question. There are also some funds that dont offer any cover for breast reduction surgery.

You can get coverage. Medical insurance may cover breast reduction surgery if its a medical necessisty not a cosmetic procedure. However as a general rule breast reduction is typically considered a cosmetic.

1192018 Once the threshold has been reached the insurance company may then consider breast reduction a reconstructive procedure for that patient and cover it. The problem is that the threshold can be different for every insurance company or insurance company reviewer. 11182016 However in order to receive cover for the procedure Medicare will need to deem it medically necessary.

It helps to have documentation from other physicians stating that the size of the breasts are causing you neck back and shoulder pain. Even though health insurance doesnt typically cover cosmetic plastic surgery unless to repair the body after an injury or accident reconstruction surgery for breast cancer treatment or fix a birth defect -- in some cases breast reduction surgery can be added to this list. Some do require 3-6 months of conservative treatment like physical therapy for neck and back pain.

Breast reduction surgery conducted for purely cosmetic purposes isnt covered by your health fund. Insurance coverage for Breast Reduction Marcromastia large breasts is a medical condition and is a covered benefit by many insurance companies. 522019 Other secondary symptoms can include breast pain and dermatitis or rashes beneath the breasts.

5142019 On the subject of whether or not your health insurance provider will cover your breast reduction procedure this will differ depending on the health insurance company and their breast reduction requirements. While all of these symptoms might be present in a woman with large breasts reduction mammaplasty may not immediately be covered by your health insurance. 7292020 Some insurance companies wont cover breast reduction unless the surgeon plans to remove at least 500 grams more than one pound of breast tissue on both sides even though studies have shown that the amount of tissue removed is unrelated to relief of symptoms.

Most insurance companies do cover breast reduction surgery if prior approval is submitted and you meet their criteria. Medically necessary situations include reconstruction after a mastectomy or reduction to help with pain. Read on to learn more.

So the good news is that in some or most cases breast reduction surgery may be covered by your health insurance. 8172020 MOst breast reductionenhancement is considered as cosmetic surgery and lots of insurance policies wont cover it. A plastic surgeon who performs breast reduction surgery on a regular basis will work diligently with you to get your insurance company to cover the procedure.

Spinal curvature with back and shoulder problems rashes a reduced ability to exercise due to the physical weight as well as psychosocial shame. However this doesnt mean that it wont be covered. 5172018 Some insurers may cover breast reduction surgery for those who have documented health problems that can be attributed to large or heavy breasts.

Breast Reduction Faqs Washington University Physician