Blog Series on Breast Reduction: The ten things you’ve been wanting to know.
Q: How often are breast reductions approved by insurance?
A: The surgery can be covered 80-90 percent of the time when the case meets your particular insurance plan’s standard criteria. There isn’t a real simple answer when it comes to approvals of breast reduction.
Insurance companies will often dictate how much breast tissue needs to be removed for them to consider a breast reduction medically necessary, and convincing them requires more than just a doctor’s letter of recommendation. You will need medical documentation such as a recent mammogram (if you are the age of 40+), all medical records on the symptoms/problems (rashes, pain, etc.) you experience due to enlarged breasts, and any physical therapy/chiropractor records if applicable.
All of these documents will be sent together with your office visit with Florida Plastic Surgery Group, and your pre-operative photos that we will photograph of you during your consultation. A panel of doctors at your insurance company will determine if a reduction is appropriate.
Usually, a removal of between 400-2000 grams (approximately 1-4lbs) is approved by insurance companies if it is a plan inclusion.