South Texas Plastic Surgery Blog

Will My Insurance Cover Breast Reduction Surgery?

Breast Reduction and Insurance - Victoria, TX

Posted on: December 10, 2016

A woman in a black braPatients who've come to our Victoria plastic surgery center know that we always strive to meet their aesthetic goals. We often try to go further, in fact, offering insight into various surgical procedures and what patients should know about them.

When it comes to breast reduction surgery (reduction mammaplasty), there are cases in which woman may qualify for insurance coverage when undergoing the procedure. Let's cover some of the basics right now.

Breast Reduction May Be Medically Necessary

While many people consider plastic surgery procedures purely cosmetic and elective, there are a number of cases in which having a surgery performed is medically necessary. Such is the case with breast reduction surgery.

For some women, having breasts that are very large can be the source of bodily pain as well as self-consciousness. When a woman's breasts are very large, it can place a great deal of stress and strain on the spine, particularly the lower back. The neck and shoulder area can also be affected given how the weight of the breasts can pull on bras, bra straps, and certain kinds of tops.

In these cases, there is a compelling and medically necessary reason to undergo a breast reduction surgery. Under certain conditions, your insurance may cover part of the procedure.

Ideal Candidates for Breast Reduction Surgery

The best candidates for breast reduction surgery are women who have breasts that are too large for their figure and frame. The size of their breasts should be such that they suffer from neck pain, shoulder pain, and lower back pain. In addition, women may want to consider the surgery if they feel self-conscious about their appearance and body type.

It's important that surgical candidates be in good overall health so the breast reduction surgery does not pose any risk to health or wellness. Knowing the risks, benefits, and side effects of surgery is also very important.

Speak with Your Insurance Provider About Potential Coverage

The first step you should take is contacting your health insurance provider about your situation and asking if there is coverage for the surgery. Policies and insurance providers vary, which means that coverage is not always guaranteed.

If your insurance provider will offer some coverage for the procedure, it's important that you follow their guidelines for obtaining the coverage that you need.

Common Steps for Breast Reduction Coverage

In many cases, the following steps need to be taken in order to receive medical insurance coverage for breast reduction surgery:

  • A letter from your physician/general practitioner about pain and physical discomfort related to the size of your breasts
  • A letter from your plastic surgeon about the surgical procedure and how much tissue will be removed

Additional requirements or paperwork may be requested by the insurance company as well.

We Will Help However We Can

If you are seeking insurance coverage for your breast reduction surgery, we will be of assistance however we can in these matters. We will be more than happy to provide necessary letters and paperwork, as well as offer advice on this process where warranted.

We will also be more than happy to go over the surgical process, from pre-op to post-op so you know what to expect. We are here for you.

Learn More About Breast Reduction Surgery

For more information about breast reduction and how it can help you have a trimmer, slimmer, and better looking figure, be sure to contact our cosmetic plastic surgery center today. Our team will work with you to improve your overall appearance.


South Texas Plastic Surgery Victoria Office 601 E San Antonio
Ste 302W

Victoria, TX 77901
(361) 576-1975

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