What does it take to get covered by insurance or breast reduction surgery?

[maria#1]

I am a DDD but it has drived me to massive low confidence sometimes Im so depressed about it. I have the MOST difficult time purchasing bras. Sometimes almost impossible. It causes me to have such a poor posture. I know that insurance covers the cost for reduction but for certain reason. How can I get them to cover this surgery?

[terri]

Complaints of back pain and other health issues usually can get you covered by insurance.

Insurance covered my reduction 100%.

[jake.jakebson]

see a doctor and ask him/her

[Tiare]

you tell them that you have constant back pain, cant sleep due to the weight of your breasts, the bra straps are digging into your shoulders, your posture is suffering. that should be plenty for a reasonable insurance company

[lunachick]

I'm not sure of your age, but a friend of mine had to wait until she was 18 to get her breast reduction surgery because it was causing her major back problems. If you can get a note from a doctor or chiropractor to show to your insurance company, you shouldn't have too much of a problem getting help beside having to jump through all of the beaurecratic loopholes. Good luck.

[kajun ladee]

You doctor will have to write a letter to your insurance company explaining that it is a much needed surgery due to your health. They need to let them know that it will be more cost effective to perform the surgery than to have future reoccurring problems which will cost them even more.

[mariebear]

Doctor has to say it is causing medical problems for you. Such as back pain, shoulder pain, etc. Something medical. Poor posture is good. But doc has to convery this to insurance. My friend had it done. It took a while.

[sdg-FNP]

This is a VERY complicated procedure....and that's JUST to get the ball rolling.

Although your insurance "may pay" for the procedure, most companies will require a stringent amount of criteria to be met; often taking months of documentation and regular follow-ups with your medical provider.

A most recent patient of mine wanted this done. She is only 15, but has had significant esteem/psychological affliction due to this, as well as physiological strain as well. Despite meeting a great deal of the required criteria, the insurance company refused because they set a required amount of breast tissue that must be removed that would have been more than she could have sacrificed. So, in the end, they did nothing despite verbal and written requests on my part.

Check out detailed information online, and see your provider about this. See if you meet the necessary criteria to get this done. Each insurance company requires their own criteria to be met, and most can be found online -- as with Aetna's link below.

Best of luck to you!