Breast Reduction Covered By Insurance: If you think about a breast reduction since it is imposing negative impacts on your appearance and well-being, then it is the time to look out whether your insurance covers that. Although there are physical and psychological benefits gained from breast reduction procedures, still it is considered as a cosmetic undertaking by insurance companies. Until it becomes a medical necessity, it seems as a cosmetic procedure by the insurance coverage. So, how do you have winning coverage under the insurance for your breast reduction? Find it here.
How a breast reduction is determined to be covered under the insurance coverage?
If an individual approaches the Breast Reduction Center for initial consultation, the person will undergo a thorough examination by the surgeon. During the consultation hours, it will be determined by the weight of tissues that have to be removed for making the breasts proportional to the body, without alleviating any health concerns. After this assessment, the surgeon will come up with a submission that goes for the view and approval of the insurance company.
If you look into the procedure of most of the insurance providers, they use a simple and standard calculation for determining the body surface area or BSA. BSA is the calculation of Height and weight once it has been established; it will be compared with Schnur Sliding Scale. Schnur Sliding Scale is a methodology to evaluate the need of a medical treatment for a breast reduction. The insurance company makes use of the scale in order to compare the body surface area to the tissue amount that is recommended by the surgeon for removal. And then they come to the determination whether the individual really needs a breast reduction for medical reasons.
Steps to make your breast reduction covered under insurance
You can get preauthorization for a breast reduction procedure by many insurance companies. This needs a recommendation from the surgeon for a report that says that you are a candidate for reduction in mammaplasty. The insurance team will go through the medical history and available information to determine whether your breast reduction is medically obligatory.
It is necessary that you make sure of the needed documents which are required by the plastic surgeon to ensure the coverage under the insurance. It is always good to ascertain whether the insurance company is looking for a second opinion on the requirement of a medical examination. This assures whether you are or partially or fully covered for the procedure.
It is also a good activity whether you can make use of an in-network plastic surgeon, which lets you with the peace of mind that you can be covered by the insurance.
The good news is most cases breast reduction is covered under the insurance and health issues like back and neck pain, skin rash development underneath the breasts are some of the reasons that make an individual to get qualified as a patient for coverage. So, we encourage the needed person to visit the policy provider with the details of reduction surgery along with the weight, height and body mass index (BMI) and necessary documentation.
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