Women seek out breast reduction surgery for a variety of reasons, but insurance only covers surgery that provides a medical or physical benefit beyond aesthetics. The distinction can vary from company to company and case to case, so it’s important to understand your company’s policies before scheduling your procedure.
If your breast reduction surgery is necessary to reduce or eliminate back pain, neck pain, strain and discomfort, or skin conditions caused by the weight and size of your breasts, your medical insurance may cover the cost. In addition, if surgery on a healthy breast is necessary to restore symmetry after breast cancer surgery or treatments, insurance covers the cost under the Women’s Health and Cancer Right Act of 1998. Most reconstructive treatment is required to be covered under this law.
Your company may have specific requirements regarding the amount of tissue to be removed and the size of the reduction. The more disproportionate your breasts are to your overall weight and frame, the more likely the company is to cover the procedure.
What Do I Need to do to Prepare?
Most insurance companies have specific requirements to qualify you for coverage of your breast reduction surgery. You should be at or near your ideal body weight- the insurance company wants to know that you’ve already done all you can to alleviate the problem without surgery. Since your breasts may shrink with weight loss, they are unlikely to provide coverage if you are very overweight, unless you can show that you’ve already made an effort, under a doctor’s care, to alleviate the problem through other treatments and programs.
How Do I Get my Insurance Company to Cover My Surgery?
You’ll need to prove to the insurance company that the surgery is medically necessary. This is where your medical team comes in. They can help you provide supporting documentation from your primary doctor, and perhaps your internist, chiropractor, orthopedist, or other specialists who have been involved with your care. The more supportive documentation you have, the better your chance at getting the insurance company to cover the procedure.
Breast Reduction in Kansas City, KS
Kansas City patients can call Dr. Rast today at (913) 451 – 3722 or schedule a free consultation online. Our team will be happy to discuss your concerns, help you get started with the pre-qualification process, and answer all your breast reduction questions today. If your breasts are causing you discomfort, call us now!