Will my insurance cover a breast reduction?

Author: Samir Daugherty Sr.  |  Last update: Thursday, September 25, 2025

Can a breast reduction be covered by insurance? Yes. Breast reductions are covered by many health insurance plans. However, your surgeon may need to authorize the procedure with your health insurance company in order to get coverage.

How likely is it that insurance will cover a breast reduction?

Insurance will cover breast reduction if you meet two criteria. One, you must have symptoms from large breasts. Second, you must have weight removed determined by your body surface area. If you are only a D or DD, it is very likely that they will not cover you since the usually criteria is 500 grams minimum.

What size breasts qualify for reduction?

There is no specific minimum breast size for reduction, as it depends on the individual's body proportions and preferences. However, surgeons typically recommend that patients have at least a C cup or larger to be considered good candidates for breast reduction surgery.

What makes a breast reduction medically necessary?

Breast reduction surgery is meant for people who have large breasts that cause the following: Chronic back, neck and shoulder pain. Shoulder grooves from bra straps. Chronic rash or skin irritation under the breasts.

Why won't my insurance cover breast reduction?

If you have been denied coverage for breast reduction, there are two possible reasons:Your insurance company does not consider surgery medically necessary. If this is the case, your surgeon can file an appeal. If the appeal fails, your only option is to pay out of pocket for surgery.

Dr. Benjamin Brown, Plastic Surgeon - Will Insurance Cover My Breast Reduction - Q & A

How do people afford breast reduction?

Breast reduction surgery is often covered by health insurance plans, but your plastic surgeon may need to get approval from your insurance company. This process may involve submitting a letter and photos.

What does your BMI have to be to get a breast reduction?

Because breast size usually goes down with weight loss, for patients over a certain body mass index BMI (for example, 30 or 35), insurance companies may deny coverage for breast reduction. Instead, they'll ask you to get your body mass index BMI below 30, 35, or another target number.

How do I get medically approved for a breast reduction?

You'll generally have to provide records showing that:
  1. You have chronic health symptoms caused by having large breasts.
  2. You have tried nonsurgical treatments for your symptoms.
  3. Nonsurgical treatments have not helped.

What would disqualify you from getting plastic surgery?

Plastic surgery has gained immense popularity, but there are several factors that can disqualify individuals. Unrealistic expectations, psychological considerations, medical conditions, inadequate finances, poor physical health, and lack of commitment to aftercare are all crucial factors to consider.

What does no one tell you about breast reduction?

Breast tissue can be very heavy and the common complaint of breast reduction patience is back pain, shoulder divots from their bra straps, and the inability to participate in sports and other activities.

Can I go down 4 cup sizes with a breast reduction?

The original size and shape of your breasts will also greatly affect the decision-making process, and your height and weight factor into deciding what size will be proportionate to your body shape. The lower limit on a breast reduction is an A cup. However, in general, patients will go down at least one or 2 cup sizes.

Who is not a good candidate for breast reduction?

However, if your Body Mass Index (BMI) is over 35, breast reduction surgery will not be covered by insurance, and it is not safe to perform.

Does a breast reduction include a lift?

So, as I previously mentioned, a lift is incorporated into every breast reduction in order to produce an ideal outcome. If you are interested in this popular procedure, I encourage you to consult with a board certified plastic surgeon who has considerable experience and proven results with the medial pedicle technique.

What is the cheapest state to get breast implants?

What is the cheapest state to get breast augmentation? According to our data above, Alabama is the cheapest state to get breast augmentation at an average of $6,000 surgeon's fee. However, we discourage price shopping when choosing your plastic surgeon for breast augmentation.

How to naturally reduce breast size?

The breasts mostly consist of adipose tissue, or fat. Losing body fat can reduce a person's breast size. Maintaining a diet and lifestyle where energy expenditure is higher than calorie intake will cause a person to lose weight. This weight loss may lead to a reduction in breast size.

When can I go braless after breast reduction?

The timeline for stopping nighttime bra use after a breast reduction varies depending on individual healing progress, but most patients are advised to wear a supportive bra around the clock for at least four to six weeks.

Who is not a good candidate for breast augmentation?

Generally speaking, anyone who is in reasonably good mental and physical health can be candidates for breast implants. However, you are likely not a good candidate for this surgery if: You're pregnant or breastfeeding. You have breast cancer or an abnormal mammogram.

What plastic surgery is considered medically necessary?

Typically reconstructive surgery is considered medically necessary to restore function and normal appearance, and to correct deformities that are congenital, trauma related or created by medical conditions such as cancer.

What is the least painful plastic surgery?

Most patients report that rhinoplasty is only a 2 to 3 on a 10-point pain scale. Comparatively speaking, it's among the least painful cosmetic surgeries.

How do I prove my insurance needs a breast reduction?

A letter showing medical necessity from your primary care physician or specialist detailing your symptoms and how they affect your daily life. A description of how the surgery will alleviate these issues. Records of any non-surgical treatments you have tried and their outcomes.

How much do DDD breasts weigh?

The average pair of DDD breasts weighs between 15 and 23 pounds. To put this into perspective, this is the equivalent of carrying around two small turkeys on your chest every day. . . . . .

What is the BMI cut off for breast reduction?

If you have a BMI of around 30 or slightly higher, your surgeon will advise you on weight loss before cosmetic surgery to ensure safe and optimal results. If you're considering breast reduction with liposuction, you'll need to have a BMI of below 35 to undergo the cosmetic procedure here at the CREO Clinic.

How big do your breasts have to be for a reduction covered by insurance?

Insurance requirements do vary by company and insurance plans, but usually, if a woman is experiencing the following their insurance might cover this procedure: Large breasts that could be reduced by at least 3 cups sizes or more (500g or more)

What do I wish I knew before getting a breast reduction?

10 Things You Need to Know Before Having Breast Reduction Surgery
  • You'll immediately feel lighter afterward. ...
  • Breast reduction surgery can improve your overall health. ...
  • You'll need to wait six weeks before wearing a traditional bra. ...
  • You might want to wait to have surgery until after breastfeeding.

How many pounds do you lose after a breast reduction?

A breast reduction may cause a dip in the number on the scales for some patients. The average weight lost after a breast reduction can range from two to eight pounds.

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