Breast Reduction: Will my insurance cover it?

This is one of the most common questions that our patients do have when calling our office. But before we go into the insurance information, what exactly is breast reduction and why would insurance cover it?

Also known as reduction mammaplasty, this procedure removes excess glandular tissue, breast fat and skin to achieve a breast size in proportion to the patient’s body. Eliminating excess weight on the breast, allows the patient to feel better about her self, to live a more active life, and to live without discomfort.

Because breast reduction is considered a reconstructive procedure, your insurance company may cover the cost. Whether you choose a doctor within your insurance plan (in network) or not (out of network) the requirements are the same.

Example: Per United Health Care – PPO services.

A patient needs to present to the insurance company the following:

_ A letter or determination or medical necessity.

_ Doctor’s notes pertaining to the patient’s case.

_ Recent mammogram (depending upon health insurance plan).

The letter of determination and the doctor’s notes can be provided to you, by our office, a few days after your initial consultation. Keep in mind that final determination will depend upon your insurance plan. However, we want you to know that our office gladly assists our patients with the requirements mentioned above.

If you are considering having a breast reduction surgery, call us to make an appointment, and we will guide you through this process. Based on what we gather from our patients, breast reduction is one of the most rewarding surgeries. Do not wait one more minute and call us…and trust us when we say that this is truly worth it!

Hope to hear from you soon,

Susan

CSA Staff