Although the process of getting breast reduction surgery covered by insurance can be challenging, it can save you a considerable amount of money, provided your claim is approved.
Obviously, the cost of breast reduction surgery can be cost-prohibitive for some people; however, it is important to note that some cosmetic surgeons do offer financing plans that can make paying for a much-needed surgery more manageable.
That said, if having the procedure covered by insurance is not an option, it may be a good idea to speak with your physician about possible financing options. Breast reconstruction is a surgical procedure that involves fixing the shape and appearance of a breast. Women who have deformed breasts due to genetics, accidents,. Your consultation will typically last about an hour and.
The decision is completely up to you. It depends on what your goals are. Research indicates that tummy tucks are among the most common types of cosmetic surgeries women undergo.
However, one of the most important details they leave. The best age for a facelift is when you want it. In some cases a facelift can be done early in life but, in most. Scot Bradley Glasberg, M. Website Design and Marketing by Promoting Image. Manhattan, NY For all other consultations please call Suffering From Chronic Pain Patients who suffer from chronic back, neck, and shoulder pain because of their overly large breasts are the most likely candidates to be eligible for coverage.
Permanent Shoulder Grooves Grooving on the shoulders from overtaxed bra straps are a symptom of heavily weighted breasts. No Alternative Treatments Have Worked Some insurance companies require you to try alternative treatments.
A Certain Amount of Tissue Must Be Removed Most insurance companies require a certain amount of breast tissue to be removed in order to qualify for coverage. Getting Your Procedure Covered If you are suffering from unpleasant symptoms that can be attributed to your oversized breasts, speak with your physician and contact your insurance company to determine your eligibility for coverage.
Previous Post Next Post. Contact Ask Dr. Taleisnik Connect with us. As it turned out, this patient had no other medical treatment or previous consultations concerning her macromastia.
She also had no history of being referred for physical therapy, chiropractic treatment, an orthopedic consultation or a dermatology exam. For many procedures, this lack of treatment history might not be an issue. But for breast reduction, which can be considered cosmetic or reconstructive, depending on the patient — and the insurance company reviewer — the lack of history for this patient would prove problematic. Unfortunately, the patient had not completed all of the regimens that her insurance required for the reduction procedure to be covered in her case.
She will be able to reapply for reduction mammoplasty coverage after the requirements have been completed, but, unfortunately, there is still no guarantee that her insurance will cover the procedure. Naturally, as a college student, she was not in the position to consider paying out-of-pocket for the procedure and was not happy to discover the insurance hurdles she would need to go through for potential coverage.
This story is just an example of why it's so important for patients to do their homework regarding their insurance coverage for any surgical procedure before seeing a surgeon. The answer to "is breast reduction surgery covered by health insurance? It is universally believed by patients that if a surgery is considered reconstructive, it is medically indicated and covered by health insurance. Conversely, many patients believe if a procedure is considered cosmetic, it is not a medically indicated and covered procedure.
In the case of breast reduction, however, for insurance purposes, it will typically be considered a cosmetic procedure until the patient can prove an adequate number of health issues and attempted remediations of those issues prior to undergoing corrective surgery. 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. It is my opinion that breast reduction surgery has long been thought of as a "hybrid" procedure. It is considered reconstructive in attempts to obtain insurance coverage for the surgery, but it is also considered cosmetic in that patients expect meticulous aesthetic expertise in their surgery and results. You may decide to have breast reduction surgery to:. Women who have breast reduction surgery are often extremely satisfied.
It can make the breasts smaller, firmer, lighter, and more evenly proportioned. It usually relieves the physical discomfort and pain caused by large breasts. The results of breast reduction surgery are considered permanent.
But the breasts may become larger or their shape may change as a result of pregnancy, weight gain, or weight loss. The most common risks of breast reduction surgery include:. Less commonly, damage to the breast's blood supply may occur during surgery.
This may delay the skin's healing process. Loss of part or all of the nipple and areola can also occur, but this is not common. These risks can be serious or even life-threatening, but they rarely occur. Keep in mind that breast reduction may make breastfeeding difficult or impossible in the future. Some women may still be able to breastfeed after having reduction surgery. If you are thinking about having a breast reduction, ask your doctor if your provincial health plan covers the costs.
Your provincial health plan may cover some or all of the costs of breast reduction surgery if surgery is being done to relieve back pain, skin problems, or other medical problems caused by large or heavy breasts. Surgery being done solely to change the appearance of the breasts is typically not covered, because it is not considered a medically necessary procedure when done for this reason. Denkler MD - Plastic Surgery. Author: Healthwise Staff.
Medical Review: Anne C. This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.
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