Breast Reduction and Insurance Coverage

Women with overly large breasts sometimes turn to breast reduction surgery to alleviate medical problems such as sore neck, back pain and in some instances, difficulty breathing. The cost of plastic surgery isn’t necessarily affordable for many women, especially on Long Island. However, some insurance companies will cover part of, or the entire cost of breast reduction because it is considered a reconstructive procedure when the correct criteria are met.

Insurance companies all have different criteria that must be met by the patient to determine if breast reduction is medically necessary in order to obtain coverage. Although requirements vary from company to company, general criterion indicate that the patient suffers from:

  • Headaches
  • Neck, shoulder, upper back pain
  • Kyphosis (outward curvature of the spine that creates a hunched appearance) as proven through x-ray
  • Pain/ulceration from bra straps digging into shoulders

Some insurance companies require patients to meet all or some of the requirements simultaneously.

Most insurance companies require documentation from a board-certified plastic surgeon that will explain why the procedure is medically necessary and will produce beneficial results for the patient. Sometimes it is required that the patient spend a specific time period attempting other methods to reduce or eliminate pain caused by large breasts. Other methods for pain management may include physical therapy to improve posture and strength, wearing a supportive bra, or non-steroidal anti-inflammatory drug therapy. It is often required of women over 40 years of age to have a mammogram taken to rule out any chance of breast cancer within 1 year of the breast reduction procedure.

The overall benefits for large breasted women to undergo reduction exceed the medical indicators discussed above. Breast reduction has many aesthetic benefits for the body. Breasts will be in a more attractive proportion to the rest of the body, and clothes will fit better. Many women who had breast reduction surgery report a significant boost in confidence and self-esteem. After breast reduction, many women become more active and engage in activities that their large breasts may have prohibited them from participating in prior to surgery. Breast reduction surgery can help women to live happier and healthier lives.

Breast Reduction on Long Island

Are you interested in breast reduction surgery? Contact Dr. Rhee today! We are located in Huntington Station, Long Island, New York, and can be reached directly at (631) 424-6707. We look forward to hearing from you soon!

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