Do you think I have a reasonable chance of getting my plastic surgery covered by insurance?
Whether an insurance company will cover breast reduction surgery is a very common question for many patients. The specific factors that matter for you will vary depending on both your insurance company and your individual policy. Insurance companies will only cover the procedure if they feel like it is a medically-necessary procedure. Size of the breasts is one factor, but symptoms of back/neck/shoulder pain, shoulder grooving, skin rashes, and skin breakdown are also very important criteria that they look at. The most important thing to do is meet with a board-certified plastic surgeon to have a thorough consultation and discuss the available options.
Getting insurance to cover breast reduction surgery is a process. It is not unusual for an insurance company to initially refuse to cover a procedure. When this happens, it does not mean that they will never cover the procedure, but they may need other information. Sometimes this means having your primary care physician state that they have treated you for your breast-related symptoms. We are here to help guide you through the process and help you achieve a great outcome.
There are times when insurance will not deem a patient with a medically-necessary problem, or a specific policy may not cover breast reduction surgery. In those cases, breast reduction surgery can still be performed as a cosmetic procedure. For more information, call our office at (770) 464-5485.
Daniel Park, MD