Breast Reduction Covered By Insurance?

For some women, having large breasts means experiencing pain every single day. This condition, also known as macromastia, often causes physical pain and brings about emotional distress. While some women may learn to live with the physical and emotional hardships that come with having large breasts, others want to address this condition with reduction mammaplasty (breast reduction). For my patients in Los Angeles, a breast reduction can enhance self-confidence in addition to providing physical relief.

Breast Reduction Methods

Before discussing insurance coverage for breast reduction, it is important to understand the surgical methods available to achieve more proportionate breasts. The goal of any reduction procedure is to remove excess fat, breast tissue and skin. There are different types of incision methods, largely dependent on how much breast tissue or fat needs to be removed.

Anchor-Shaped Incision: This method uses an incision circling around the areola, descending down vertically toward the bottom of the breast, and running horizontally along the crease of the breast. The nipple (still attached) is then moved to a higher position on the breast, and the excess tissue, fat or skin is removed. The breast is then lifted and tightened.

Lollipop Incision: This technique is typically utilized when less skin or tissue needs to be removed. Also known as the short-scar method, the incision encircles the areola and descends vertically down the breast. Excess skin and tissue is removed at this time.

Liposuction: Liposuction may be performed along with a breast reduction to help reshape the breast. While not always used with breast reduction, liposuction can help remove fat from under the arms and around the bottom of the breast crease. It can also be performed on its own as a way to reduce the size of the breast, but this is not very common.

Insurance Considerations

Because this procedure is far more than cosmetic, many insurance carriers will offer full or partial coverage for breast reduction surgery. However, many women remain unaware of what their insurance will cover. In almost all cases, an insurer will require that the procedure is being performed for medical reasons in order to extend coverage.

Often, the physical discomfort of large breasts is one of the factors in determining insurance coverage. Some of the physical difficulties associated with having large breasts include stretched skin, back and neck pain, headaches, poor posture, grooves in the shoulders from bra straps, and the inability to exercise.

Before insurance companies cover the cost of a breast reduction procedure, they first need to make sure that oversized breasts are not the result of being overweight. For heavier patients, Insurance companies require a larger amount of breast tissue to be removed for the surgery to be covered.

Your Individual Case

Some patients' insurance companies cover the entire cost of the procedure, while others cover only a portion of the cost. Not all insurance companies provide the same coverage. After meeting with a surgeon and determining if you are a good candidate for breast reduction surgery, submitting necessary documents to insurance companies is important as pre-certification is required for reimbursement or coverage. As a final note, for those who have had a mastectomy and require a breast reduction on their normal breast to achieve symmetry, under federal law, insurance companies are required to pay for the cost of this procedure.

Breast Reduction: Is It Covered By Insurance?

A big chest can be a burden for many women. It can hamper exercise, make breaking difficult, cause lower back pain, and make it challenging to find clothes that fit well. Breast reduction can eliminate these problems, but the surgery is expensive. The good news is that it can sometimes be covered by health insurance.

Cosmetic surgery has something to offer just about anyone who has a problem with the way they look. While many women are going in to see a surgeon to get implants, another portion of the female population is going to those same surgeons to get a breast reduction. Of course, there are reasons other than vanity to get this procedure. A big chest can be a burden for many women. It can hamper exercise, make breaking difficult, cause lower back pain, and make it challenging to find clothes that fit well. Of course, as with any form of cosmetic surgery, breast reduction can be expensive.

The good news is that it can sometimes be covered by health insurance.

If you’re thinking about getting the procedure done and want to see about getting it covered by insurance, the best first stop is your family practitioner. Talk to him about the surgery and explain the types of problems you’ve been having that are leading you to consider this option. He will be able to advise you on the best course of action and may be able to refer you to a good doctor or clinic. He may also be able to act as an advocate on your behalf, increasing the chances that your health insurance will pay for the operation. As long is there is a verifiable medical reason for you to have the surgery, there’s little reason why insurance would be unwilling to cover it. These reasons could include back pain, poor posture, chest pain, or even spinal issues.

Another option you have is to simply call your insurance company yourself and ask them about their benefits as it pertains to breast reduction surgery.

They will have concrete example of what they will and won’t cover, and for what reasons, so you shouldn’t have to worry about them playing games with you to try and talk you out of filing a claim. If they have a clause that covers the cost of the procedure for medical reasons, you then will simply need to provide them with documentation that you have the medical issues that would induce them to shell out the money.

Of course, the next step is to find a good surgeon who accepts your insurance plan. It will be in your benefit to choose a doctor who is in your insurance plan’s network so as to further save out of pocket money on the cost of the procedure. The clinic or doctor’s office will be well prepared to answer your questions, as they deal with the same questions on a daily basis. They will also know the kind of criteria and documentation the insurance companies are looking for to help them decide whether or not to cover the costs and will be able to provide the company with this information.

Get the relief you finally deserve by getting a breast reduction in Columbus, Ohio. For more information, visit http://www.donaldsonplasticsurgery.com

Breast Reduction: Is It Covered By Insurance?

Cosmetic surgery has something to offer just about anyone who has a problem with the way they look. While many women are going in to see a surgeon to get implants, another portion of the female population is going to those same surgeons to get a breast reduction. Of course, there are reasons other than vanity to get this procedure.

A big chest can be a burden for many women. It can hamper exercise, make breaking difficult, cause lower back pain, and make it challenging to find clothes that fit well. Of course, as with any form of cosmetic surgery, breast reduction can be expensive. The good news is that it can sometimes be covered by health insurance.

If you're thinking about getting the procedure done and want to see about getting it covered by insurance, the best first stop is your family practitioner. Talk to him about the surgery and explain the types of problems you've been having that are leading you to consider this option. He will be able to advise you on the best course of action and may be able to refer you to a good doctor or clinic.

He may also be able to act as an advocate on your behalf, increasing the chances that your health insurance will pay for the operation. As long is there is a verifiable medical reason for you to have the surgery, there's little reason why insurance would be unwilling to cover it. These reasons could include back pain, poor posture, chest pain, or even spinal issues.

Another option you have is to simply call your insurance company yourself and ask them about their benefits as it pertains to breast reduction surgery. They will have concrete example of what they will and won't cover, and for what reasons, so you shouldn't have to worry about them playing games with you to try and talk you out of filing a claim. If they have a clause that covers the cost of the procedure for medical reasons, you then will simply need to provide them with documentation that you have the medical issues that would induce them to shell out the money.

Of course, the next step is to find a good surgeon who accepts your insurance plan. It will be in your benefit to choose a doctor who is in your insurance plan's network so as to further save out of pocket money on the cost of the procedure. The clinic or doctor's office will be well prepared to answer your questions, as they deal with the same questions on a daily basis. They will also know the kind of criteria and documentation the insurance companies are looking for to help them decide whether or not to cover the costs and will be able to provide the company with this information.