For many women, breast enhancement surgery isn’t about adding more; it’s about eliminating excess. A breast reduction can mean freedom from back pain, the end of discomfort and greater self-esteem. But at what cost? Insurance can sometimes cover breast reduction, but be prepared for a process of proving that it’s not purely cosmetic and that you meet the breast reduction weight requirements.
Navigating Your Insurance
Insurance companies today are ever-changing, and no two companies are alike. Policies and processes have become more difficult to navigate, which is why it’s more important than ever to be diligent about documentation. Your first step in your breast reduction journey should be calling your insurance provider and getting detailed instructions on what you need to do to have your reduction covered.
Insurance companies may use several metrics, including weight of tissue to be removed, to determine whether or not a breast reduction is covered. You may also need to get a referral from your primary care physician instead of initially contacting a plastic surgeon directly.
The Approval Process
Once you’ve educated yourself on your insurance company’s protocol, you can start the approval process. This often involves a series of recommendations for breast reduction surgery from doctors and photos to be sent to your insurance provider for review. Sometimes approval also relies on breast reduction weight requirements for tissue removed. According to health.com, the requirements fall in the range of 400 to 2,000 grams which is roughly 1 to 4 pounds.
Each insurance provider is different, so it’s important to consult with your insurance company throughout the process. If you have large, heavy breasts that are causing significant discomfort and limiting your freedom of movement, get the ball rolling and schedule a breast reduction consultation today.
Dr. Lee B. Daniel earned his medical degree from Vanderbilt University (Phi Beta Kappa and summa cum laude) in Nashville. He then served a five-year general surgery residency at Emory University Affiliated Hospitals in Atlanta and a two-year fellowship at the prestigious University of Texas Southwestern Medical Center in Dallas. He came to Eugene in 1999 after eight years of private practice in his home state of Kentucky.