How To Get A Breast Reduction Covered By Insurance

It required an act of Congress for having large heavy breasts to be acknowledged as a cause of multiple medical conditions including. Unless you can privately pay for your breast reduction surgery it is recommended to do the following before your breast reduction procedure to see about insurance coverage.

I M Getting A Breast Reduction Consultation Insurance Coverage Youtube

Breast reduction surgery will generally be construed as a cosmetic procedure unless the patient can prove that they have an underlying health condition that can only be remediated by undergoing the.

How to get a breast reduction covered by insurance. 6302020 Youll qualify to have your breast reduction covered if you meet Medicares conditions. 382019 Generally speaking breast reconstruction surgery is only covered by insurance if the procedure is deemed medically necessary but everything is not always black-and-white. Again that price may be different based on your coverage level and out-of-pocket maximum.

Steps to getting insurance coverage for breast reduction surgery. The best way to obtain insurance coverage for breast reduction surgery involves some hoops to jump through. In my office we have an insurance coordinator to help patients get approved for breast reduction.

In this video I talk about the steps taken to get a get a breast reduction. 5172018 Appealing breast reduction results sometimes necessitate a breast lift mastopexy of the remaining breast tissue and nipple. Check your insurance policy to see if such a procedure could be covered or partially covered to alleviate symptoms you are experiencing.

Call your insurance company to see if a pre-authorization letter is needed for breast reduction. Check if your insurance has an exclusion for reduction mammoplasty. Even though these facts may make it seem that your health insurance should logically cover part or all of your breast.

Spinal curvature with back and shoulder problems rashes a reduced ability to exercise due to the physical weight as well as psychosocial shame. In the case of breast reduction for reconstruction after. 172019 Not too long ago breast reduction surgery was not covered by insurance at all.

This is called the Schnur scale and is based on a patients height and weight. A primary care physician will document the pain you are having and go over the long-term effects of neck and back pain. 8232018 Usually all your doctor needs to do is either call the insurance company to get authorization for the breast reduction and give medical reasons that make it a necessity or fax a copy of your medical record with reasons you need the breast reduction done.

1192018 On average it takes between 3-6 months of preparation including secondary consultations with other healthcare providers and possible therapy physical therapy or chiropractics to qualify for insurance coverage for breast reduction. Additionally they usually require for a certain percentage or amount of breast tissue to be removed in order to qualify. I also talk about my experience in the consultation and how I ended up so short w.

282018 You may only qualify for coverage if a certain amount of breast tissue needs to be removed. Meet with Your Primary Care Physician When looking to get a breast reduction covered by insurance it is important to meet with your primary care physician to discuss your symptoms from dense heavy breast tissue. On average it takes between 3-6 months of preparation including secondary consultations with other healthcare providers and possible therapy physical therapy or chiropractics to qualify for insurance coverage for breast reduction.

982018 Keep in mind some insurance companies require a trial of physical therapy to treat neck and upper back pain and or documentation from a doctor for treatment of rashes before they will authorize a breast reduction. The more documentation you have for example from your primary care doctor physical therapist chiropractor etc the better when it comes to obtaining insurance authorization for the procedure. It is simply a chart that states the weight of tissue that needs to be removed relative to a your height and weight to be considered a reduction and not a breast lift.

Schedule a consultation with us. Insurance coverage for Breast Reduction. 2192015 If your insurance does include breast reduction as covered benefit your plastic surgeons office may be able to help you with the necessary paperwork.

5142019 Prices will be different but the national average for a breast reduction procedure itself not including hospital stays or anesthesia costs is around 7000 - 8000 out-of-pocket before insurance is applied. 1082019 Schedule your consultation Most insurance plans need to know that your procedure is considered medically necessary to be able to cover your breast reduction. Wait for an answer from the insurance company.

Hope this helpsTracy Pfeifer MD Tracy Pfeifer MD Board Certified Plastic Surgeon.

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