American Society of Plastic Surgeons
For Medical Professionals
one year ago


Does most insurance carriers accept this type of procedure or will it require out of pocket payments

Procedure: Breast Reduction
Location: Scranton, SC

Replies 2

Gary Culbertson
ASPS Surgeon
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Coverage of a Breast Reduction is determined by the Insurance Carrier. Doctors no longer dictate health care. Insuance company's do becuase, you are paying them for the covered services. Check with your personel insurance plan to see if they cover the surgery you are considering.


Gary R Culbertson, MD, FACS

Samir Shureih

Whether insurance companies cove the surgery of reduction mammoplasty or not woud depend on the the individual insurance company. Review your contract or call your insurance carrier and ask

1: do they cover reduction mammoplasty

2: what are the conditions to cover the surgery

3: Do they cover hospital and free standing surgical center, or hospital, or accredited office surgical center, and how much$ ?

4: Do they cover the surgeons fees and how much?

5: What is the minimum weight to be removed from each breast for the insurance to cover expenses

6: Do you have to see an in their network of the insurance?

Do they cover expenses if you chose out of network ?

7: do you need to lose weight before they cover expenses?

8: do you need to have physical therapy documentation before they cover the expense?

9: What other requirements do they need BEFORE SURGERY they need?

10: do they need referral by your family doctor?

Have all these questions answered before surgery in writing.


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