Does Insurance Cover Breast Reduction?

Insurance doesn’t typically cover cosmetic surgery; however, breast reduction isn’t always a cosmetic procedure. Breast reduction is a good option for women who have physical issues caused by too much breast tissue. This problem can sometimes stress supportive parts of your body and cause pain in your back, neck, and shoulders. You may also deal with posture issues if you have too much tissue or heavy breast tissue. You might be prone to skin conditions like rashes, chafing (or other irritation), and even infections around your breasts. All of these are medical issues and may prompt your insurance to cover a breast reduction to help relieve your symptoms.

Factors That Affect The Cost Of Breast Reduction

If your insurance won’t cover breast reduction, what are your options? Fortunately, medical financing companies and credit cards can help you pay for your procedure over time instead of in one lump sum.

Say your insurance won’t cover your surgery, and you will have to pay for your breast reduction out-of-pocket. You need to know what your costs will be. So, what factors influence the price of your surgery? You can expect your costs to vary depending on the following:

• Pre And Post-Op Appointments
• Anesthesia Dosage

• Surgeon’s Fee

• Facility Choice 

• Regional Location Expenses (Cost Of Living)

According to Care Credit, a medical credit card company, the cost of breast reduction in the United States ranges from $7,995 to $12,850, with a national average of $9,002.

Will Insurance Cover Your Breast Reduction?

In some cases, insurance will cover the cost of breast reduction if it’s medically necessary. What conditions/symptoms make breast reduction a necessity?

• Back, neck, or shoulder pain that won’t improve with other treatment
• Repeated cases of skin irritation, rash, or infection around the breasts
• Difficulty breathing, especially when lying down
• Chronic mobility and exercise issues

Insurance Criteria For Breast Reduction Coverage

While insurance may cover your breast reduction, you’ll likely have to go through a few steps to receive this coverage. One thing most insurance companies will require is that you seek alternative treatments like physical therapy or chiropractic adjustments to deal with pain and mobility issues before you can move forward with your breast reduction.

If you’ve been dealing with pain, skin conditions, or other issues caused by large breast tissue, talk to your doctor. Not only will they be able to provide you with the treatment you need (such as cream for skin irritation), but they can also refer you to a physical therapist or chiropractor to help with the pain. Plus, going to your doctor with the problem can help you keep a record for insurance purposes. This documentation does two things:

1. It shows that, yes, you’re having medical issues related to breast size.
2. You’ve been seeking alternative treatment that hasn’t improved your condition.

If you try alternative methods of treatment and don’t see results, depending on your insurance, you should be eligible to receive insurance coverage for your breast reduction surgery.

Explore Financial Options For Your Cosmetic Procedures

At Allure Esthetic, we work with three financing companies to make sure you can access the care you need without feeling the financial sting of surgery. Call or text (206) 209-0988 to learn more about your options.