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Breast Reduction and Insurance

By on March 15, 2013

Breast Reduction and InsuranceWe've discussed a number of breast enhancement surgery topics on the blog. One important surgery that people sometimes don't think about so much is breast reduction surgery. There are some instances where the procedure may be deemed medically necessary rather than a cosmetic/elective procedure. This makes prospective candidates for breast reduction curious about medical insurance and the surgery.

When you meet with a San Antonio plastic surgeon in person, this issue can be discussed in greater detail. Right now, we'd like to look at the issue in basic terms so you have a better understanding of the matter.

About Breast Reduction Surgery

San Antonio breast reduction is performed in order to reduce the size and improve the shape of breasts that are pendulous or too large for a woman's frame. Not only does this improve the figure and body contour, it can help ease stress on the rest of the structures in the body.

Why Breast Reduction Surgery May Be Medically Necessary

Breasts that are too large can cause pain in the lower back due to excessive weight that needs to be supported. Similarly, pain in the shoulders, upper back, and neck can be caused by bra straps digging into the skin.

The Breast Reduction Surgery Procedure

The breast reduction surgery is actually performed in a manner similar to the breast lift. For extensive reduction surgeries, three incisions will be made: one around the areolas, another along the crease where the breast meets the lower chest, and a final incision connecting these two that follows the lower contour of the breast. (Picture the shape of an anchor.) Through these incisions, excess fat, glandular tissue, and skin is removed from the breast.

Common Requirements for Insurance Coverage

Each health insurance plan will vary in terms of coverage requirements, but in general, there are a few things that must happen.

First, patients must meet with their physician to determine if breast reduction surgery is medically necessary. Generally these sessions will involve examinations of back, shoulder, and neck pain related to the breasts, as well as an account of the patient's height, weight, and body type in relation to their breast size.

If the general physician deems it medically necessary, he or she will then need to furnish a referral letter to a plastic surgeon. A meeting at a San Antonio cosmetic plastic surgery center will then need to occur, and a plastic surgeon will need to perform an examination and furnish official documentation of the treatment plan. A certain percentage of breast tissue will need to be removed during the surgery in order to qualify for coverage.

The Real First Step: Contact Your Insurance Provider

The above is only a basic breakdown of the requirements for insurance coverage. If you believe a breast reduction may be medically necessary, contact your health care provider and find out what they require to authorize coverage. For example, some insurance companies may want to know the bras you wear as a result of the issue, any pain medications you've had to take due to pain, and any physical therapy you've had to attend as well.

By knowing what your insurance provider is looking for ahead of time, you can prepare the proper letters and documents as needed. This will reduce chances of a rejected claim and allow you to prepare ahead accordingly.

Learn More About Cosmetic Plastic Surgery

If you would like more information about breast reduction surgery as well as your many other options for body contouring and aesthetic enhancement, be sure to contact our San Antonio cosmetic surgery center today. Our entire practice is eager to meet you in person and help you make the best decisions regarding your aesthetic and general wellness goals.

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San Antonio Office

9502 Huebner Rd
Bldg 2, Ste 202
San Antonio, TX 78240

Open Today 9:00am - 4:30pm

All Hours Directions (210) 614-0400