Will My Insurance Cover My Breast Reduction?

Breast reduction surgery can be a significant blessing to women who chronically suffer from issues related to having disproportionately large breasts. Many insurance policies will cover the cost of the procedure provided that the evidence supports this being of a reconstructive nature and not of a cosmetic one. Even if it is not covered by insurance, the benefits of a breast reduction can far outweigh the costs as it can significantly and permanently improve your quality of life.

Breast Reduction Before & After Photos - Dr. Turkeltaub

Some Are Covered; Some Are Not

Insurance companies typically have policies that address covered and noncovered procedures. Some plans specifically exclude coverage for breast reduction surgery whereas others provide coverage that is contingent on meeting stringent and often burdensome proprietary criteria. Therefore, to determine if this is a covered benefit and, then, if you can qualify for insurance covered breast reduction, you will have to review your specific policy. When you come in for your consultation, Dr. Turkeltaub and his office staff will help you to determine your eligibility for insurance coverage.

Common Criteria for Insurance Coverage

There are many different requirements for insurance covered breast reduction. Here are some of the most common criteria to qualify:

  • Neck, back, and/or shoulder pain directly related to the weight of the breasts
  • Skin infections or rashes
  • Shoulder grooves
  • Documentation and duration of symptoms monitored by your primary care doctor
  • Doctor recommended surgery from a medical specialist such as a chiropractor, neurologist, or orthopedic surgeon
  • Breast weight that exceeds a specified amount that is based on one’s height and weight
  • Failure to respond well to pain medication, physical therapy, chiropractic care, acupuncture, or other forms of treatment for symptoms

Consider How the Benefits Outweigh the Costs

Even if you do not qualify for insurance-covered breast reduction, you can still undergo the procedure by paying on your own. This procedure can drastically improve your quality of life by improving or alleviating issues such as neck pain, shoulder pain, breast sagging, skin irritations, shoulder grooves, breast asymmetry, inability or limited ability to exercise, self-consciousness, reduced self-esteem, unwanted attention, poor clothing fit, and more. To help make it more affordable for you so that you can enjoy these benefits, we offer special pricing packages with our anesthesiologist and outpatient center as well as financing options if needed.

Find out more about breast reduction surgery and how to afford it privately or with insurance coverage by scheduling your personal consultation with Dr. Steven Turkeltaub. Call (480) 451-3000 or fill out our online contact form to schedule your appointment today.