It depends. Typically if breast reduction is covered, it is covered in situations where there is a medical reason supporting the medical necessity of the procedure. Breast reductions to enhance appearance are usually considered cosmetic. But each insurance plan is different. A person considering breast reduction needs to check with their insurance company to understand their policy and exactly what it covers.
A Answers (3)
Elif Oker, MD, Emergency Medicine, answered
Michael A. Howard, Plastic & Reconstructive Surgery, answered on behalf of NorthShore University HealthSystemFor a majority of patients insurance companies do cover breast reduction surgery. Learn more from Dr. Michael Howard on behalf of NorthShore University HealthSystem.
Stuart Linder, MD, Plastic & Reconstructive Surgery, answeredInsurance may pay for your breast reduction depending upon the amount of tissue that will be removed. Each policy has exclusions, limitations, and requirements of breast tissue removal in gram weight per breast. In general, larger reduction mammoplasties are covered to alleviate back pain, neck strain, grooving of the brasierre along the shoulders, and rashes under the breasts. Documentation and photographs are often required during the preauthorization process.