Woman with overly large breasts often suffer from a variety of physical and emotional symptoms, and may be interested in exploring the possibility of breast reduction surgery. Most insurance plans do cover breast reduction when performed for medical reasons but the patient must meet the specific surgical criteria and the surgery must be considered medically necessary. In this article, we’ll explore insurance coverage for breast reduction as well as financing options for the procedure.
Insurance Coverage for Breast Reduction
Many insurance companies will cover breast reduction surgery when performed for “medically necessary” reasons. This means that the patient must have a diagnosis of large breasts that are causing medical problems, such as back and neck pain, headaches, shooting pains, numbness or tingling in the arms or legs, or an inability to participate in physical activity. The most common medical problem is upper back pain. Additionally, insurance may sometimes require that the patient has tried non-surgical treatments like physical therapy, medication, and weight loss before they’re willing to consider coverage for breast reduction surgery.
Many insurance companies also require the patient to meet certain surgical criteria. The National Institutes for Health qualifications include a minimum of 500 grams of breast tissue on each side, extensive documentation from previous medical records, pre-operative photos, and a six-month period of conservative medical management. The patient may also be asked to meet certain weight criteria.
Financing Options for Breast Reduction Surgery
For many women, breast reduction surgery is an out-of-pocket expense if insurance doesn’t cover the procedure. In these cases, there are a variety of financing options available. Many plastic surgery practices offer in-house payment plans, where the patient can make monthly payments over a fixed period of time. These plans are generally interest-free and can help to make the surgery more affordable.
There are also third-party lenders that specialize in medical loans for procedures like breast reduction surgery. Medical loans can provide the patient with a flexible payment plan and usually offer competitive interest rates. Some medical loans can even be used to cover additional expenses like post-surgical garments, medications, or ancillary fees without any additional collateral or income verification.
Many plastic surgery practices also participate in the CareCredit program. CareCredit is a credit card that can be used to pay for medical fees. It offers flexible payment plans, low monthly payments, and no interest if the balance is paid off within a predetermined period.
In conclusion, breast reduction surgery is often covered by insurance when performed for medical reasons, but the patient must meet certain criteria. If the surgery is not covered, there are a variety of financing options available to help make the surgery more affordable. Woman considering breast reduction surgery can discuss their options with their surgeon to develop a payment plan that works for their budget.