How do I get a breast reduction?

This process starts with an internet search for “Breast Reduction policy guidelines for XXXX” (replace XXXX with your insurance company). This will give you insurance requirements that you must satisfy for you to qualify through insurance. Most of these items you will need to document ahead of time, through office visits with your primary care provider. 

Once you and your primary care provider believe you qualify and you have the written documentation (office notes), you may call a plastic surgeon’s office to schedule a consultation. During the consultation, many things will be discussed. The surgeon will estimate is the amount of weight that will be removed while achieving your desired cup size. This is an estimation. This weight must be above the insurance minimum weight requirement, in order to qualify for breast reduction. This is usually the reason why a patient does not qualify.

There are things that can be done to still qualify. You can tell the surgeon that you are willing to be a smaller cup size after surgery. This will allow the surgeon to remove more weight and maybe meet the insurance requirements. You can lose weight. If your weight is less, your body surface area (BSA) is less, thus the weight required by insurance will be less. And you might qualify for the breast reduction. 

The other option is to undergo a self-pay breast reduction. Some insurance companies make it very difficult to qualify for the average person. This is also an option to consider. You might be able to switch to a different insurance company (the policies are very different, some are very friendly to breast reduction patients, while others make it very difficult). Do your homework, research your options.