What Do I Need To Do To Get Insurance To Cover My Breast Reduction?
Q: I am 24 years old, 5′ 4” tall, weigh 135lbs, and have 38DD breasts. Am I a good candidate for breast reduction and could it be covered by insurance? My back, shoulders and neck are always sore and I get migraines in the back of my head all the time. I wear loose clothes to hide my hideously large breasts and I would never even think of wearing a swimsuit for fear that I might fall of it! I just want to be physically and emotionally happy, but its hard with my unproportioned body due to my large breasts. Insurance is the only way possible for this surgery to happen if I qualify.
A: Based on the size of your breasts and your height and weight, it would seem likely you’re your breast reduction would qualify for insurance coverage based on my experience. But whether one’s medical insurance will provide can not be determined by your plastic surgeon. Insurance coverage for breast reduction requires a predetermination letter to be sent by your plastic surgeon with specific qualifying information. Your height, weight, breast cup size, history of medical symptoms associated with your large breasts, what non-surgical treatments have been attempted, and how much breast tissue in grams is to be removed is the needed information. This letter, complete with photographs of your breasts, will be submitted for their review. They will then determine if you qualify and their decision with be returned by letter to you in about 4 to 6 weeks after submission.
Dr. Barry Eppley