Many insurance companies have very strict guidelines in place before they will approve any patient for a breast reduction. The best way to determine whether or not you are eligible is to speak with your physician about the problems your breasts are creating and your insurance company to see if you match their criteria.
Considerations
Insurance companies only consider covering a breast reduction if the candidate suffers severe back pain--especially in the upper region of the back--and if the breasts are large enough to rub together, causing constant skin irritation. These rashes can often be severe enough to cause sores under and between the breasts, and are often painful. Insurance companies may want you to try exhausting all other options before they consider covering a breast reduction.
Effects
Overly large breasts can have various effects on a woman. Some women suffer mental distress from having to bear the weight of so much breast tissue; other women may be plagued with constant back pain. If you've tried chiropractic services, physical therapy and back braces to ease the effects of large breasts, you may be able to convince your insurance company to cover the costs of a reduction.
What You Need
In order to be considered for a breast reduction, get a copy of all of your medical documentation stating the problems you have suffered. Sign consent forms for release of any information from your doctor, physical therapist or chiropractor relating to the issue of a breast reduction. Insurance companies may request picture documentation, as well as your height and weight, in order to proceed with the determination proceedings.
Prevention/Solution
In order to ensure that you get approved, follow all of the recommendations that your insurance company and family physician provide. Fredrick J. Duffy Jr., M.D., states that "although some medical research indicates loss of weight will not result in a decrease in the size of breasts, some insurance plans will require a patient to first lose weight prior to trying surgery."
Advice
Your insurance company will contact you once your application for a breast reduction has been reviewed to let you know whether you have been approved or denied. If you have questions regarding the procedure in determining your eligibility, call your insurance company and ask. If you have been denied, you're allowed to ask why and find out what you can do to appeal.
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