Breast Reduction and Insurance

BY DENNIS HURWITZ ON DECEMBER 02, 2012

Breast Reduction and Insurance

While there are cases where a woman is looking into breast reduction surgery for reasons that are purely cosmetic, that is usually not the case. Most patients who want breast reduction surgery are looking for relief from pain. There are many medical afflictions that result from large breasts and can lead a patient to seek breast reduction surgery.

• Back pain is a common complaint of women with large breasts, especially those who have a disproportionate body size to accommodate the size of the breasts
• Neck and shoulder pain as a result of the strain of supporting the size of the breasts
• Limited ability to perform physical activities such as sports and exercise, which can lead to a sedentary and unhealthy lifestyle

If there are medical reasons for your breast reduction surgery, it is likely that your insurance company will cover the costs of surgery either in part or full. The first step that a patient should take is talking to the insurance company. Most insurance companies will have criteria that need to be met before surgery can be covered. While these requirements will vary by insurance company, some common requirements include:

• Choosing a surgeon that is within your insurance company’s network
• Having documentation from your surgeon showing that you suffer from medical conditions as a direct result of your breast size
• Showing the need for at least half a pound of weight to be removed from each breast
• Providing photos that show the need for breast reduction surgery
• Being within a healthy weight range and in good enough health to undergo surgery

Even if these criteria are met, you will want to have a clear understanding of all the costs that will be covered. For instance, for many of our patients in Pittsburgh, liposuction is performed as a part of breast reduction surgery; you will want to know if these costs will be covered as well. Dr. Hurwitz can work with you and your insurance company to make sure that any necessary documentation is provided so that you can get the maximum coverage from your insurance company.

Schedule a Consultation

You do not need to live in pain. If you would like to learn more about breast reduction surgery, schedule a consultation with Dr. Dennis Hurwitz. Dr. Hurwitz and his staff look forward to helping you reduce your level of pain and discomfort.