How to Make Your Insurance Company Cover Your Breast Reduction Surgery

breast reduction covered by insurance
breast reduction covered by insurance

A common question regarding breast reduction surgery is:
“Will it be covered by insurance?”
I hate to be vague about it but the answer is, “Sometimes.”

To be certain that your insurance company will authorize breast reduction, here’s what you need to do:

Establish that breast reduction is medically necessary

For a procedure to be deemed medically necessary, you have to have symptoms that are causing you problems, basically creating a medical condition.

Such problems include:

  • Neck pain
  • Back pain
  • Shoulder pain
  • Skin irritation

… or basically anything related to large breasts.

Document those problems

Your doctor should document those issues and send it to your chosen plastic surgeon.

Another option is to directly go to a plastic surgeon and let him document those issues by taking your medical history and physically examining you, relating to some of the symptoms that would deem this procedure as medically necessary.

Make sure that it’s a covered procedure

Unfortunately, not all insurance companies cover breast reductions at all. So, you need to have a contract saying that it’s covered given it fulfills the necessary criteria.

But don’t worry if it’s not covered by your insurance company.

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