Breast Reduction Surgery – Your Insurance May Cover This Procedure

Breast Reduction Surgery – Your Insurance May Cover This Procedure. Polyclinic Plastic Surgery with Dr. Phil Haeck, board certified plastic surgeon for more than 25 years. Visit us online at or call 206-860-4684

Video transcript:
If you have very large breasts and this is causing symptoms such as back, neck pain shoulder pain postural changes, headache and rashes your insurance company might consider paying for a breast reduction.

There are several steps to go through if you want to know if your coverage can be pre-authorized to pay for this important procedure.

First of all you should check with your health care insurance to find out if a breast reduction is a covered benefit of your personal policy. Many companies list on their web site the qualifications needed to obtain this procedure.

Next, many insurance companies will require that you have had trials of conservative treatment for your back, neck and shoulder pain.

This usually includes at least six months of one or more of the following therapies:

Physical therapy
Therapeutic massage
Chiropractic adjustments
Prescription pain medication

If you have failed to improve more than just temporarily with these treatments then documentation of how many treatments you had and over what period of time may be necessary.

Once you have gotten to this point the next step is to meet with a qualified, board certified plastic surgeon. He or she will examine you, take measurements and determine, based on your height and weight, how much tissue will need to be removed in grams from your breast to qualify for coverage.

Most insurance companies follow a sliding scale called a nommogram, and the surgeon will communicate with them to get pre-authorization. Many insurance companies also require a photograph of your chest without any identifying details taken by the doctor and sent in with his request.

If full documentation of your trials of conservative treatment is needed you may be required to help obtain those records and forward them to your insurance company.

Once you have been assured of your coverage for this procedure you can schedule it with your surgeon at a convenient time. Most surgeons recommend just two weeks off from work after the surgery.

Visit us online at or call 206-860-4684