Will Insurance Cover My Breast Reduction?

Board-Certified Plastic Surgeon in National Harbor Accepting New Patients Near Washington DC, Arlington, Fort Washington, Maryland & Virginia

Posted: September 25, 2015

When considering a breast reduction, Maryland patients often wonder if the procedure will be covered by their insurance. Despite the overwhelming physical and emotional benefits of breast reduction surgery, affordability can ultimately be a deciding factor.

Of all plastic surgery procedures, breast reduction surgery boasts one of the highest patient satisfaction scores.  For many women in Maryland, the procedure provides life-changing improvements to their health, confidence, and freedom of movement.  However, that doesn’t mean that insurance will cover it.

Each insurance plan specifically details breast reduction policies. Some plans exclude breast reduction outright, or qualify the procedure as cosmetic.  For those plans that do cover the surgery, some require a specific amount of tissue to be removed, or require weight loss, physical therapy or medical documentation of related health issues to qualify.

If you are considering using insurance to cover your breast reduction surgery, your first step should be to contact your insurance company. If your plan does provide coverage, you may be required to provide one or more of the following:

  • Photographs and measurements to support your claim
  • A recent mammogram
  • Documentation that you have sought medical attention multiple times in the past year for neck pain, shoulder pain, headaches or upper back discomfort
  • Documentation of that treatments for your symptoms, such as anti-inflammatory medications, have failed
  • Documentation that three to six months of chiropractic care or physical therapy has been ineffective

It is also important to remember that pre-authorization is not a guantee that your provider will ultimately pay for the surgery, and even if it does, reimbursement can take several months.

Bella Cosmetic Surgery offers several financing options, and will work with you to help find a solution that best matches your needs and current financial situation.

If you are considering breast reduction in Maryland, please contact Bella Cosmetic Surgery today by calling 301-567-6767 or by completing the form on this page today to schedule a consultation with Dr. Chiaramonte. Our National Harbor office welcomes patients from Northern Virginia and Washington D.C.