Women frequently undergo breast reduction surgery as a result of ongoing physical discomfort related to having large breasts. However, when it comes to getting your health insurance provider to cover your reduction surgery, you may find that there are some hoops to jump through. Here are three tips for getting your breast reduction covered by insurance.
1. Have Documented Health Issues Related to Breast Size
It’s not enough to simply say that you have ongoing back pains or skin problems resulting from large breasts. Insurance companies always need documented evidence. Have your general physician or back pain specialist write up an official report of your health problems, clearly linking them to breast size.
2. Take Steps on Your Own, If Needed
Some insurance companies won’t cover breast reduction unless the patient has taken steps on her own to resolve the problem. This usually means an attempt at weight loss through diet and exercise. Whenever possible, document your actions so that you can show your provider if requested. Consider hiring a personal trainer who can provide you with further documentation of your efforts.
3. Know Your Insurance Provider’s Requirements for Coverage
Finally, it’s important to know your insurance provider’s specific requirements for coverage of breast reduction. Every health plan is different. For instance, most providers require that a minimum amount of breast tissue is removed for the procedure to be considered for health rather than cosmetic purposes, but the exact amount will likely vary among different insurance companies. Be sure to work closely with a breast reduction specialist who can help you meet the needs of your health insurance provider, as well as assist you in skillfully navigating any red tape involved.
With over 25 years of active practice, Dr. Michael Halls is recognized as a leader in breast surgery procedures in Southern California. Dr. Halls graduated Alpha Omega Alpha and Cum Laude from Medical School in Canada and completed seven further years of training in Plastic Surgery Residencies and Fellowships including two years in Boston at Harvard and Massachusetts General Hospital.
He is Board Certified in Plastic Surgery in the United States (FACS) and Canada (FRCS(C)) and is an active member in international, national, and local societies for breast and plastic surgery. Dr. Halls has published multiple papers in journals and texts over the past four decades and has appeared on many local and national TV programs.