FAQ Insurance Questions: Breast Reduction

FAQ Insurance Questions: Breast Reduction

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FAQ Insurance Questions: Breast Reduction
FAQs

Will My Breast Reduction be covered by insurance?

Insurance coverage for a breast reduction procedure depends on a variety of factors and will be discussed in detail at your consultation. If insurance coverage is possible, a pre-determination will be sent to your insurance plans prior to scheduling. This will ensure there is an approval on file for medical coverage prior to surgery. If an approval is received you may still be subject to your deductible, out of pocket payment, and co-insurance under your plan’s terms and conditions.

If a denial is received our office can file an appeal. If that appeal is then overturned into an approval you will be contacted and scheduled. If the denial is upheld you can work with our cosmetic coordinator to proceed with scheduling.

Most insurance providers require clinical notes from physicians as well as photographs. Other documentation that may be helpful are notes from physical therapists, chiropractors, and proof of other methods that were used to try and alleviate discomfort prior to surgery.

Breast reductions can be considered a cosmetic procedure unless an adequate amount of health issues and attempted remediation of those issues has occurred prior to surgery. Every insurance company will have different criteria that needs to be met prior to approving breast reduction surgery.

It will be helpful to call member services located on the back of your insurance card. By doing so, you will speak to a representative who can offer information about your specific plan. Many insurance plans also have online medical policies that can be found on the plan’s homepage.

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Northwestern Specialists
Plastic Surgery

676 N St Clair Street, Suite 1575
Chicago, IL 60611

Monday-Friday 8a-5p
Saturday: 9a-2p
Sunday: closed

The Med Spa Streeterville

676 N St Clair Street, Suite 1575
Chicago, IL 60611

Monday-Friday 8a-5p
Saturday: 9a-2p
Sunday: closed

The Med Spa River North

3 E Huron Street, 3rd Floor
Chicago, IL 60611

Monday-Thursday: 10a-7p
Friday 9a-5p
Saturday: 9a-5p
Sunday: 10a-2p

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