Will Insurance Cover My Breast Reduction Surgery?

While you love your full bosom, your overly large breasts feel like a ton of bricks weighing on your shoulders. At most times, they make you feel uncomfortable. Whenever you exercise, you feel conscious. Besides that, you can’t find a sports bra that provides maximum support. Every summer, you develop rashes in the skin beneath the breast crease because the skin in the folds can’t breathe.
Your extremely large breasts may make you feel more awkward than sexy, so you may feel ready to bring them a cup size or two smaller.
There’s just one problem.
You’re not sure if your insurance will cover the cost of a breast reduction surgery.
Well, the good news is most medical insurance policies cover breast reduction surgery. However, this depends on a case to cases basis. The only way to find out if your procedure is under coverage is to call your insurance carrier. Insurance policies are unique to individuals, so yours may differ from your friend’s, sister’s, or mother’s.

If your insurance policy does cover breast reduction surgery, there may be criteria that they will consider. The most common criteria that you can get coverage involve the following:
• A removal of breast tissue of at least 500 grams or one-half pound from each breast.
• Your surgeon must provide an accurate diagnosis that you suffer from disabling or debilitating symptoms attributed directly to overly large breasts.
• Your surgeon must attest that you have tried every possible means to resolve your condition personally without success.
• You are at or at least close to your ideal body weight.
• Your surgeons can provide photos that document your need for a breast reduction surgery.
Another factor that you need to consider is to check if Dr. Clinton is in-network or out-of-network with your insurance policy. Some insurance policies will only cover the surgery, be it in full or partial, but not the professional fee of the surgeon, which could affect the surgery cost.
Generally, insurance can cover your breast reduction surgery if it’s for a medical need. If you plan to have the procedure purely for cosmetic reasons, you’ll need to include in your consultation the total cost, which may include anesthesia, overnight stay at the surgery center suite, and follow-up visits.
Breast reduction surgery can be costly. However, it’s worth the investment when your health is at stake. Besides, there are financial institutions that can help with the cost if your insurance can’t cover it. If you want to learn more about the financial aspects of breast reduction surgery, Dr. Clinton and his staff at Clinton Plastic Surgery will be happy to assist you. Request a free consultation today.