Will My Insurance Approve A Breast Reduction for My Larger Asymmetric Breast?
Q: Dr. Eppley, I have severe breast asymmetry. Left is a D cup and right is an A cup. I also have very large areolas and my breasts are pendulous. Because they are so uneven I have had upper back soreness and other aches and pains. Would insurance cover me at all? It is just as disfiguring as other birth defects and even cancer. I am not at all exaggerating.
A: Whether your medical insurance would cover the reduction of your larger D cup breast is a determination of the insurance company. No physician can say with any certainty whether they will or won’t. This requires a written letter with photographs by a plastic surgeon to your insurance company. This is known as a pre-determination process. Once they have this information, they will then make either an approval or denial in a written response. They will definitely not cover any form of a breast lift such as may be needed on the smaller right breast and this would not even be submitted, lest it jeopardize any potential approval of the left breast reduction.
Dr. Barry Eppley