Is Breast Reduction Plastic Surgery Covered by Insurance?

Breast Reduction Plastic Surgery Covered by Insurance, Is Breast Reduction Plastic Surgery Covered by Insurance?Breast reduction is one of the few cosmetic surgery procedures where insurance coverage may be possible in specific cases. The insurance company needs to be convinced that breast reduction is medically necessary. This will require more than just the surgeon’s recommendation, and the patient will have to submit genuine medical evidence. Outstanding, cutting edge, and board certified plastic surgeon Dr. Hisham Seify provides breast reduction to patients in Newport Beach, Orange County, CA, and surrounding communities.  

Medical Proof

When a patient seeks breast reduction surgery, one of the first steps the surgeon will take is to determine her candidacy. After a basic physical exam, the surgeon may find one or more characteristics such as:
  • The breasts are excessively large for the patient’s frame
  • Breasts are pendulous and heavy, causing rashes or redness in the breast crease or fold
  • One breast appears to be larger than the other
  • The patient has typical indentation marks on the top of each shoulder where bra straps have pressed into her skin for years
To qualify for insurance and to collect medical evidence, the surgeon will photograph the patient from neck down. These pictures will have to be provided to the insurance company. The photos as well as the surgeon’s report may be evaluated by the insurer’s panel of doctors to determine whether breast reduction plastic surgery is a medical necessity in a specific instance.  

Standard Considerations

Insurance companies typically make the call by relying on a set of charts that consider height, weight, and the amount of removable tissue in each breast. If the amount of tissue to be removed meets the standard criteria of the insurer, the costs of surgery may be covered by them. Women with DD, DDD, and H cups usually qualify. However, it is important to note that each case is considered on its individual merit, and there is no guarantee that meeting the standard criteria alone will qualify the patient for insurance coverage. Even if the coverage is approved, the deductibles would have to be borne by the patient.  

Tips for Patients

  • Read your insurance policy terms and conditions carefully or check the insurer’s online resources for your specific type of health insurance to determine whether breast reduction is potentially covered.
  • Call the insurer to check if pre-approval is required for breast reduction surgery.
  • Ask the type of documentation the insurer requires from your surgeon as well as your family physician to establish medical necessity.
  • If the insurer appreciates that medical symptoms arising from oversized breasts are likely to require ongoing expensive treatment, they will be more inclined to approve insurance coverage for breast reduction surgery.
  • Find out if your insurance company requires a second medical or surgical opinion before approving coverage for your breast reduction.
  • Check whether there is a possibility of combined coverage for breast reduction and breast lift, if you need to undergo both surgeries together.
Experienced and successful cosmetic surgeon Dr. Seify receives patients from Newport Beach, Orange County, CA, and other cities and towns in this region of the state for breast reduction surgery. See more procedures and treatments by plastic surgeon Dr. Hisham Seify in Newport Beach, Orange County, , Irvine, Anaheim, Fullerton, Los Angeles, Beverly Hills, CA and surrounding areas.

Comments are closed.

Liposuction | Body Contouring| Tumescent Liposuction| Liposuction Surgery| Fat Removal| Vaser Liposuction| Liposuction Cost| Cosmetic Surgery| Laser Liposuction| Liposuction Laser| Plastic Surgery| Liposculpture| Liposuction Procedures| Lipoplasty | Mini Tummy Tuck| Abdominoplasty| Lower Abdomen| Mini Tummy Tuck Consultation| Cosmetic Surgery| C-section Scar Revision| Mini Tummy Tuck Cost| Body Contouring| Umbilical Hernia Repair| Mini Tummy Tuck Candidate| Excess Skin Removal| Mini Tummy Tuck Results| Muscle Tightening | Post Bariartic Surgery| Stretch Mark Removal| Reconstruction Surgery| Body Transformation| Post Bariatric Reconstruction Surgery| Cosmetic Surgery| Body Lift| Combination Procedures| Arm Lift| Restoring Pre-Pregnancy Figure | Smart Lipo | SLaser Liposuction | SLaser-Assisted Liposuction | SSmart Lipo Procedure | SBody Contouring | STargeted Fat Reduction | SSmart Lipo Surgery | SFat Removal | SSkin Tightening | SSmart Lipo Cost | SMinimally Invasive Procedure | SSmart Liposuction | SPrecision Body Sculpting | Tummy Tuck | Tummy Tuck Surgery | Abdominoplasty | Tummy Tuck Cost | Breast Augmentation | Cosmetic Surgery | Breast Enhancement Surgery | Breast Enlargement | Breast Augmentation Procedure | Implant Options | Breast Augmentation Cost | Breast Enhancement | Breast Implants | Explant Surgery | Implant Deflation | Breast Implants Removal | Breast Implant Extraction | Implant Rupture | Breast Implant Removal Surgery | Implant Removal Procedure | Breast Explantation | Capsulectomy | Breast Implants Removal Surgery | Breast Revision Surgery | Breast Lift | Sagging Breasts | Breast Reshaping | Breast Lift Surgery | Breast Ptosis | Breast Positioning | Breast Lift Cost | Nipple Repositioning | Breast Lift Procedures | Breast Firming | Mastopexy | Breast Contouring | Breast Reconstruction | Mastectomy | Nipple Reconstruction | Breast Reconstruction Surgery | Tissue Expander | Breast Reconstruction Treatment | Implant Reconstruction | Breast Reconstruction Cost | Autologous Reconstruction | Breast Cancer Reconstruction | Flap Reconstruction | Breast Reduction | Reduction Mammaplasty | Breast Reduction Surgery | Large Breast Reduction | Breast Reduction Procedure | Breast Hypertrophy | Breast Reduction Surgery Cost | Breast Size Reduction | Breast Reduction Price | Breast Revision | Implant Replacement | Breast Revision Surgery | Capsular Contracture | Breast Revision Surgery Cost | Implant Malposition | Breast Implant Revision | Implant Rupture | Corrective Breast Surgery | Gynecomastia | Male Breast Reduction | Male Breast Reduction Surgery | Male Breast Reduction Cost | Enlarged Male Breasts | Face Lift | Facial Rejuvenation | Deep Plane Lift | Face Lift Surgery | Facial Aging | Mini Face Lift | Face Lift Procedures | Sagging Skin | Mid Face Lift | Facelift Cost | Wrinkle Reduction | Rhytidectomy | Facelift Techniques | Brow Lift | Brow Ptosis | Brow Lift Techniques | Brow Lift Surgery | Sagging Eyebrows | Endoscopic Brow Lift | Brow Lift Procedures | Forehead Wrinkles | Direct Brow Lift | Brow Lift Cost | Eyebrow Positioning | Temporal Brow Lift | Eyebrow Lift Surgery | Upper Face Rejuvenation | Neck Lift | Neck Contouring | Neck Lift Surgery | Neck Rejuvenation | Neck Lift Surgery Cost | Neck Lift Surgery Procedures | Cervicoplasty | Chin Implants | Plastic surgery | Facial implants | Chin implant types | Chin Implant Surgery | Cosmetic procedure | Chin reshaping | Chin implant benefits | Chin Implant Cost | Chin augmentation | Facial symmetry | Chin implant consultation | Chin Implant Procedure | Facial harmony | Chin augmentation surgery | Chin implant candidates | Facial contouring | Jawline enhancement | Facial aesthetics | Ear Surgery | Ear pinning | Earlobe repair | Otoplasty Surgery | Cosmetic surgery | Ear surgery procedure | Otoplasty Procedure | Ear correction | Ear surgery benefits | Ear Surgery Cost | Prominent ears | Ear surgery risks | Ear Surgery Price | Ear reshaping | Ear surgery recovery | Eyelid Surgery | Cosmetic surgery | Eyelid surgery procedure | Eyelid Surgery Cost | Eyelid rejuvenation | Eyelid surgery benefits | Blepharoplasty | Eyelid lift | Eyelid surgery risks | Upper Eyelid Surgery | Upper eyelid surgery | Lower Eyelid Surgery | Lower eyelid surgery | Anti-aging Treatment | Holistic wellness | Anti-aging Treatment Cost | Preventive healthcare | Anti-aging | Regenerative medicine | Integrative medicine | Longevity | Age management | Anti-aging consultations | Hair Transplantation | Hair Transplantation Procedure | Hair Transplantation Cost | Hair transplant consultation | Hair transplant before and after
NewportPlastic