How can I get my insurance to cover a breast reduction?
Breast reduction is commonly considered a reconstructive surgical procedure (although there is a cosmetic component to it), so the surgery may be covered by health insurance if it is performed to relieve medical symptoms.
What qualifies you for breast reduction?
Who is a good candidate for breast reduction surgery?
- You are physically healthy.
- You have realistic expectations.
- You don’t smoke.
- You are bothered by feeling that your breasts are too large.
- You have breasts that limit your physical activity.
- You experience back, neck and shoulder pain caused by the weight of your breasts.
Is breast reduction ever covered by insurance?
Most insurance carriers will offer breast reduction covered by insurance as long as it meets certain requirements to be deemed “medically necessary”. Traditionally the main point an insurance company considers is the amount of tissue to be removed from each breast.
Do you need a referral for a breast reduction?
Q: Do I need a GP referral for a Breast Reduction Consultation? No. If you are happy to pay the consult fee and not recieve the medicare rebate, you do not need a referral. If you wish to recieve a medicare rebate for your consultation visit, then you will require a referral from your GP.
When is breast reduction considered medically necessary?
The goal of medically necessary breast reduction surgery is to relieve symptoms of pain and disability. If an insufficient amount of breast tissue is removed, the surgery is less likely to be successful in relieving pain and any related symptoms from excessive breast weight (e.g., excoriations, rash).
What BMI do you need for breast reduction?
Body mass index (BMI). Some insurance companies will deny breast reduction surgery unless the BMI is <30, others <35, while others need to see documentation that the patient has attempted to lose weight in the past through diet, exercise or weight loss surgery. This is because breast size may decrease with weight loss.
When is breast reduction medically necessary?
Breast reduction surgery is meant for women who have large breasts and want to resolve issues such as: Chronic back, neck and shoulder pain that requires pain medications. Chronic rash or skin irritation under the breasts. Nerve pain.
How does a breast reduction cost?
The average cost of breast reduction (aesthetic patients only) is $5,913, according to 2020 statistics from the American Society of Plastic Surgeons. This average cost is only part of the total price – it does not include anesthesia, operating room facilities or other related expenses.
How do I prove that my breast reduction is medically necessary?
Determination of medical necessity should be based on your doctor’s report of your symptoms and physical changes caused by your breast weight. Even though trials of non-surgical treatments may have little chance of success, they may be preconditions for insurance coverage of surgery.
How much does DD cup breast weigh?
between 15 and 23 pounds
A pair of D-cup breasts weighs between 15 and 23 pounds — the equivalent of carrying around two small turkeys. The larger the breasts, the more they move and the greater the discomfort.
Is there a weight requirement for a breast reduction?
Some insurance companies will deny breast reduction surgery unless the BMI is <30, others <35, while others need to see documentation that the patient has attempted to lose weight in the past through diet, exercise or weight loss surgery. This is because breast size may decrease with weight loss. 3.
Is breast reduction covered by insurance?
Breast reduction is usually covered by insurance when the surgery is performed as part of a medically mandated procedure to treat neck, back, or shoulder pain or other problems related to the spine.
What is the average cost of breast reduction?
The cost of a breast reduction usually ranges from $5,000 to $7,000. This estimate includes an anesthesia fee of $1,000 to $1,500 and a facility fee of $500 to $2,000 as well as the surgeon’s fee, which averages $5,500, according to The American Society for Aesthetic Plastic Surgery.
Is 56 to old for breast reduction surgery?
Answer: No age limit for breast reduction 56 is not too old for breast reduction but you will need to have a medial clearance for general anesthesia. Since you are only a size 38 DD, the amount remoed will not be excessive. There is a new technique called The Ultimate Breast Reduction.
What is breast reduction?
Breast reduction is a cosmetic surgery procedure that reduces the size and weight of large, heavy breasts, helping to create a more aesthetically pleasing breast contour that is better proportioned to a patient’s body. By removing excess breast tissue, fat, and sagging, stretched skin,…