- breast reduction
- breast surgery
- plastic surgery
- plastic surgery costs
Breast reduction surgery is a tremendously rewarding procedure for patients. many women with very large breasts feel overwhelmed by the extra weight, frustrated that they have difficulty finding “regular” clothes that enhance their shape, and tired of always having to wear messy underwear instead of cute lingerie.
In addition to these cosmetic concerns, women with large breasts often experience physical and emotional discomfort. larger breasts can cause posture problems, skin rashes and pain in the upper body, and limit the ability to comfortably participate in physical activities. Emotionally, large breasts can take their toll in the form of unwanted attention or harassment, self-esteem issues, and self-loathing.
Reading: When is breast reduction surgery covered by insurance
A combination of the above factors is often what motivates women to consider breast reduction surgery. If this procedure is on your mind, you’re probably curious as to whether your insurance provider can cover it. The answer to this question can be confusing for patients, since breast reduction is considered an elective surgery.
Does insurance ever cover breast reduction?
First things first: Yes, private health insurance sometimes covers breast reduction surgery. however, some criteria must be met to qualify, and there will most likely still be some out-of-pocket costs. To receive coverage for the procedure, Medicare must deem it medically necessary. breast reduction surgery performed solely for cosmetic reasons is not covered by health insurance.
When does insurance cover breast reduction surgery?
See also: How Much Does a Psychologist Visit Cost Without Insurance in 2021? | Mira
Your private insurer may cover breast reduction surgery if your referring physician says it is necessary for your health and well-being. Having large and heavy breasts causing chronic pain and health conditions constitutes a medical reason for breast reduction surgery. You may qualify if you have any of the following symptoms:
- neck pain
- shoulder pain
- back pain
- migraines
- skin irritations
- excessive perspiration around or under the breasts
- difficulty breathing
- numbness of the hands and fingers
- restriction from exercise and other activities physical
- underlying medical conditions, such as rheumatoid arthritis
Your doctor will need to provide information to support your claim to your insurance company.
what level of coverage is required for breast reduction surgery?
Private health insurance is available at various levels to suit different people’s coverage needs and budgets. the specific treatments and procedures covered by these policies differ between funds, and not all levels cover breast reduction surgery. you must have a high-tier or possibly mid-tier policy to receive a benefit for your breast reduction surgery.
To find out if the cost of the procedure can be covered and the level of coverage available, you should refer to the specific terms and conditions of your health insurance policy.
what are the out-of-pocket costs for breast reduction?
See also: How does car insurance work when you are at fault
Even if you have medical reasons to have breast reduction surgery and you have the appropriate level of coverage with your private health insurance, you will still be responsible for some out-of-pocket costs. insurance will usually cover some or all of your hospital expenses. you will be largely responsible for the surgeon’s fees, anesthesiologist’s fees, and assistant’s fees, although small reimbursement may also be available for these costs.
is a medicare item number needed for breast reduction surgery?
Coverage from your private health insurance provider will only apply if your circumstances meet the criteria for a medicare item number. this may require exams, documentation, imaging tests and/or photographs from your doctor. these mbs item codes may be applicable for breast reduction:
- 45523: Breast reduction surgery, bilateral (both sides) in the following conditions:
- for patients with macromastia who experience pain in the neck or chest region shoulder; and
- not with the insertion of any prosthesis (breast implant)
- in the context of breast cancer or developmental abnormality of the breast
- in the context of breast cancer or developmental abnormality of the breast
what are the next steps?
She is excited about the possibilities of breast reduction surgery and is ready to learn about her insurance options. Whats Next? schedule a consultation with a plastic surgeon to find out if you qualify. this must be an in-person appointment so your condition can be properly assessed and documented. Your plastic surgeon or a member of the team at your surgeon’s office will inform you of the anticipated cost of your surgery and guide you through the process of applying for insurance coverage.
schedule a breast reduction consultation with dr. ellis choy
For the many women who suffer from debilitatingly large breasts, breast reduction surgery offers profound relief, improved quality of life, and restored confidence. Aesthetic breast reduction is not only one of Dr Choy’s most popular procedures, it is one of the most impressive and satisfying for his patients. it is an honor to bring women back to life with this transformative procedure.
contact specialist plastic surgeon dr. ellis choy about breast reduction in the sydney area by calling (02) 8962 9388 or submitting an inquiry online.
See also: Personal Liability in Travel Insurance | Fast Cover
- breast reduction
- breast surgery
- plastic surgery
- plastic surgery costs
