Is Breast Reduction Covered by Insurance?
If you are reading this article, you are likely considering breast reduction. It has become more and more common to consider a breast reduction procedure. There are many reasons that women consider breast reduction which can include post-childbirth changes or that your breasts have become so large that they are hindering everyday activities such as exercising. A breast reduction procedure that can benefit you in many ways.
Many women wonder if your insurance benefits cover a breast reduction surgery. If you are asking yourself, “does insurance cover breast reduction?” you are not alone. Our office is asked this question frequently and we work hard to ensure that our patients know all of their options and exactly what their insurance company will provide and what they will not cover.
There are Many Reasons You May Be Considering Getting Your Breast Reduction Covered by Insurance
Unlike many places on our body, it is often very difficult to lose weight in the breasts. It has become a bit of a catch 22. For example, many women seeking to lose weight can perform all the cardio exercise that they can, while still not losing weight in their breasts. However, having extremely large breasts can also lead to pain when performing cardio exercise such as running, leading to a hindrance to do so, hence the catch 22.
If you are considering breast reduction surgery cost may be an issue when considering the procedure. However, what many women don’t know is that there are important factors that are considered when you are trying to get a breast reduction surgery through your insurance company. This is ideal for women who truly struggle with having breasts that are interfering with their everyday life and activities.
If you are considering having your breast reduction covered by insurance, here are a few different important points that can help make your case for a breast reduction covered by insurance.
See a Chiropractor or Physical Therapist for Neck and Back Pain
For many women, one of the reasons they are considering having breast reduction surgery in the first place is due to back pain, neck pain, shoulder pain, or just general stress on the back area. The first step is typically to visit a physical therapist or chiropractor in order to have your specific pain looked at. During your visit make sure you mention that you are considering a breast reduction surgery to alleviate your pain. Ask them to make a specific note on your patient file documenting your symptoms of pain and discomfort. These visits will show them that your symptoms are truly causing you pain and that you have made additional attempts to remedy them prior to going the route of surgery.
Meet with Your Primary Care Physician
When looking to get a breast reduction covered by insurance, it is important to meet with your primary care physician to discuss your symptoms from dense heavy breast tissue. A primary care physician will document the pain you are having and go over the long-term effects of neck and back pain. Don’t forget to include minor pains like being uncomfortable due to pain from bra straps digging in deeply. This will give you another example to show that you have a real physical problem and are not just seeking a cosmetic breast reduction surgery.
Meet with a Plastic Surgeon
Meet with a plastic surgeon, specifically one that specializes in breast reduction surgeries. A consultation will demonstrate that you are being proactive in gathering information to help make the best informed decision regarding a surgical procedure. A plastic surgeon will be able to write a letter of medical necessity which will highlight the important history of neck and back pain along with the treatments and recommendations of your other doctors. A plastic surgeon will include as part of that letter the number of grams to be removed from each breast that is an important parameter for the insurance company to review as part of the pre operative authorization process.
Insurance companies may require pre operative photographs as part of the pre authorization process for a breast reduction procedure. As part of the insurance pre authorization each insurance company will let the physicians office know if photographs are required.
Note Specific Activities That Are Affected by Your Breast Size and Pain Caused
These can also include physical symptoms, such as being uncomfortable sitting at work all day with your bra straps digging sharply into your shoulders. While these are not medical proof you need back pain, it gives insurance company a better idea of why you should have breast reduction surgery insurance covered.
A breast reduction surgery can have many great benefits and help you live a more confident, active lifestyle. 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. 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. Most insurance companies just want to make sure your surgery is not being performed for cosmetic reasons.