Breast Reduction and Insurance: Will Your Provider Cover You?

The size, weight, and proportion of overly large breasts can make you feel self-conscious about your appearance and result in uncomfortable physical symptoms. To alleviate discomfort, improve your overall well being, and enhance your figure, Dr. David Passaretti can perform breast reduction surgery. During this procedure, he will remove excess skin, fat, and tissue from your breasts. Although it is typically considered a cosmetic procedure, breast reduction surgery offers numerous medical benefits, meaning that some carriers may cover its costs. Read on to learn more about breast reduction and insurance coverage from our Fairfield plastic surgery team.

The Procedure

To perform beast reduction surgery, Dr. Passaretti will administer intravenous sedation or general anesthesia to keep you relaxed and comfortable. Next, he will create an incision around your areola and, if necessary, down to your breast crease and across it. Using this opening, Dr. Passaretti will remove unwanted tissue and fat from your breasts, shaping them to achieve an attractive, natural look. In some cases, he will use liposuction to remove larger areas of excess fat. Once he has finished modifying the tissue of your breasts, Dr. Passaretti will pull your skin smooth and trim it to minimize drooping or folds.    

Is Your Reduction Medically Necessary?

Each insurance provider has different standards for what makes a breast reduction medically necessary (in which case, the costs would be partially or completely covered). In general, your procedure may be considered a physical need if:

• Having heavy breasts results in severe neck or back pain.  
• You have undergone treatment, such as the use of medications, chiropractic adjustments, or massage, to treat your back and neck pain.
• You suffer from chafing, infection, or other dermatological conditions as a result of heavy, sagging breast tissue.
• Your bra creates deep, uncomfortable grooves in your shoulders.
• Your breasts must be reduced by two cup sizes (or equivalent weight in proportion to your figure) or more. Many insurance companies consider less intensive procedures to be aesthetically focused and therefore elective.

At your initial consultation, Dr. Passaretti will examine your breasts, go over your medical records, and discuss your desired results with you to help you determine if your insurance may cover your expenses.

Pursuing Insurance Coverage

If you’d like your health insurance provider to pay for some or all of the costs of your breast reduction, you will need to prove that this surgery is medically necessary. To do so, you may need to send your insurance company reports from your physicians, diagnostic photographs of your breasts, and any other information required to establish your medical need. Dr. Passaretti and our team can help prepare this information and send it to your insurance provider.

Find Out More about Breast Reduction

If you are able to demonstrate the medical necessity of breast reduction, you may be able to more affordably undergo this procedure. Dr. Passaretti and our team can help you throughout this process to improve your overall health. Contact our plastic surgery practice today to learn more about breast reduction and insurance or schedule a consultation with Dr. Passaretti.