Will My Health Insurance Cover Breast Reduction?

Will My Health Insurance Cover Breast Reduction?

Breast reduction and insurance coverage in Greenwich, CT

Breast reduction and insurance coverage in Greenwich, CT
Top Greenwich plastic surgeon Dr. Sandra Margoles has met with hundreds of women who are interested in breast reduction in order to seek relief from overly large breasts. One of the most common questions Dr. Margoles hears from patients is, “Will my health insurance cover breast reduction?” Dr. Margoles discusses the answer in this blog post.

Breast Reduction and Health Insurance

Many women choose to undergo breast reduction because they are bothered by the appearance of their overly large breasts. They may feel self-conscious and embarrassed by the unwanted attention they receive because of their large breast size. In addition, some women may have a negative body image of themselves because they feel their enlarged breasts are disproportionate to the rest of their body. Breast reduction can boost self-confidence and a woman’s self-image. When breast reduction is performed solely to improve the appearance of the breasts and relieve emotional distress, it is considered to be solely cosmetic and therefore is not covered by health insurance.

Some health insurance plans cover a portion or all of the cost of breast reduction if the procedure is deemed “medically necessary.” Breast reduction is considered to be a medical necessity if overly large breasts cause physical discomfort in the forms of:

Chronic back, neck and shoulder pain. It’s not uncommon for women with enlarged, heavy breasts to have bad posture or slouch due to the weight of their breasts. This in turn can lead to chronic back, neck and shoulder pain.

Skin irritation and rashes. Overly large breasts can make it difficult for sweat to evaporate underneath the breast crease, which can lead to irritation and rashes.

If you are considering breast reduction surgery and wish to have it covered by your insurance plan, you will have to contact your provider and request that they forward you their specific criteria for coverage. Every provider is different but most require two to three documented reports from referred specialists before they consider covering breast reduction surgery. Dr. Margoles’ team can help you verify your insurance coverage and file the necessary claims with your provider.

To learn more about breast reduction, schedule a consultation with Dr. Margoles. Contact her Greenwich plastic surgery practice by calling (203) 869-2939 or emailing us today.

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