Breast Reduction

Insurance Coverage for Breast Reduction Surgery

For some patients, breast reduction surgery is a purely cosmetic procedure that allows them to meet their aesthetic goals. However, in a large number of cases, breast reduction is performed in order to eliminate physical pain and reduce physical limitations that have resulted from overly large breasts that are disproportionate to a patient’s body frame. When breast reduction surgery is considered medically necessary, it may be covered by insurance.

Qualifying for Insurance Coverage

For patients who are considering a breast reduction, it is important to carefully examine insurance coverage material before scheduling surgery. Patients who have policies that offer coverage for breast reduction surgery will likely need to receive approval prior to the surgical procedure. This eliminates the risk of the patient being denied coverage and being responsible for the surgical costs after the procedure has already been performed. When coverage is offered, it is in cases of medical necessity. The following symptoms are often signs that breast reduction surgery may be deemed medically beneficial:

  • The patient is experiencing pain in the neck, shoulders or back as the result of large breasts
  • The patient has suffered from skin rashes or irritation in the folds of skin beneath the breasts
  • The patient’s posture has suffered under the weight of the breasts
  • The patient has physical limitations due to the size or weight of the breasts
  • The patient’s breasts are disproportionate in size to their body frame

For patients with these symptoms, Dr. Allison can likely make a medical recommendation for breast reduction surgery. For patients who do qualify for insurance coverage and receive approval from their insurance for the procedure, the amount of coverage that is available will vary by the patient’s individual insurance plan. 

No patient should have to suffer the emotional or physical pain of overly large breasts. If you are interested in learning how breast reduction surgery can free you of the physical and emotional limitations of heavy breasts, schedule an appointment with Dr. Allison today. Contact Dr. David W. Allison by calling 703-754-8228 or visiting mdallison.com.