Excessively large breasts can lead to various physical and emotional challenges. Many women experience neck pain, back pain, or shoulder pain due to the weight of their breasts. Issues like skin irritation and grooves from bra straps are also common. These symptoms can make everyday activities uncomfortable and negatively impact self-confidence.
While a breast reduction can alleviate these problems, many women are concerned about how to get breast reduction covered by insurance. Below, we’ll go over the costs associated with this surgery and how insurance coverage factors in.
How Much Does Breast Reduction Cost?
While we certainly understand wanting to know more about breast reduction surgery cost, you really need to book a consultation appointment to get these facts. Breast reduction cost can vary widely depending on several factors.
Breast Reduction Cost Factors
Many elements influence the cost of a breast reduction procedure. The complexity of the surgery, the surgeon’s expertise, and the location of the practice are major factors. Additional considerations include post-operative care and whether the procedure includes skin tightening or other enhancements. Understanding these factors can help you plan financially.
Who Is a Good Candidate for Breast Reduction?
Women with physical symptoms caused by large breasts are often good candidates for breast reduction. Chronic neck pain, shoulder pain, and back pain can make this surgery beneficial. Skin irritation and bra strap indentations are other common reasons to consider the procedure.
If you’ve tried other treatments like physical therapy or pain medication without relief, breast reduction surgery may be an effective solution. Maintaining a stable weight and having good skin elasticity may improve the results of the surgery. And finally, it’s important to be in good physical health and to be a non-smoker.
How to Get Breast Reduction Covered by Insurance
In addition to learning more about cost information, we also understand wanting to know how to get a breast reduction covered by insurance. Unfortunately, this isn’t something we can directly tell you how to do. First of all, there are many breast reduction weight requirements and other health requirements just to qualify for the surgery itself—even if you pay out-of-pocket.
Health insurance may cover a breast reduction if it is considered medically necessary. But do note that insurance carriers often require documentation proving the surgery is needed to relieve physical symptoms. This might include notes from a primary care physician or physical therapist. Keep in mind that health insurance company requirements vary, so you’ll need to confirm coverage directly with your provider.
Tips for Getting Your Breast Reduction Covered
Provide medical documentation
Insurance companies often require proof that your breast reduction is medically necessary. This can include records from your primary care physician outlining physical symptoms, treatments tried, and their outcomes.
Understand your insurance policy
Review your health insurance policy to understand the requirements for coverage. Some insurance providers require that a specific amount of breast tissue be removed. Others may require you to try non-surgical treatments like physical therapy or pain medication first.
Work with your surgeon’s office
An experienced plastic surgeon’s office can help guide you through the insurance approval process.
Follow up with your provider
Staying in contact with your insurance company is essential. Ensure they have all the documents they need and clarify any outstanding requirements.
FAQs: Breast Reduction Surgery
How do I prove my breast reduction is medically necessary?
To prove medical necessity, you’ll need documentation of breast size and other physical metrics, including documentation of physical symptoms and treatments you’ve tried. This can include notes from a primary care physician, records from physical therapy, and proof of ongoing pain or discomfort.
Can Medicaid cover breast reduction surgery?
Can Medicaid cover breast reduction surgery?Medicaid services may cover breast reductions if they are deemed medically necessary. Requirements vary by state, so it’s important to consult both your surgeon and provider.
Will I have breast reduction scars?
Breast reductions require incisions, so yes, even with an experienced plastic surgeon, this means you will have at least a few light breast reduction scars. Fortunately, they will fade with time and are placed discreetly. Book an appointment to know more about where your incisions and scars are likely to be.
Will my insurance cover a breast reduction and lift?
Basically all breast reductions include a lift, so if your insurance will cover the reduction, then the lift should be covered as well.
Call to Set Up a Consultation
At your consultation appointment, you can find out more about breast reduction recovery, see breast reduction before and after photos, and ask all the questions regarding how to get breast reduction surgery covered by insurance that you may have. Board-certified plastic surgeon Dr. Ashley Steinberg would be delighted to sit down and speak with you about these topics and more.
Please contact us today to schedule your personal consultation appointment with Dr. Steinberg. We look forward to your call!
