Coverage

It is very unlikely that Medicaid would cover your breast reduction. However, even if they would cover the procedure , you would have to go to a surgeon who participates in Medicaid, which might be hard to find.

If Medicaid or insurance does not cover or help cover your surgery, an option would be to visit an International member of the American Society of Plastic Surgeons as myself (Mexico) for reduced costs for comparable surgery.

Medicaid may or may not cover the procedure. Medicaid is different in that they will not precert a procedure and the determination of payment will be done after the procedure is done and many times they will refuse payment no matter what and pay very little. The problem is not the payment as most surgeons would accept a smaller payment to help a patient in need but the hassle that they have to put up with that is the problem. That is the reason a lot of surgeons will not take Medicaid. Surgery should be done close to where you live and going to Mexico for this would be an absolute abomination. It will cost you quite a bit to travel to Mexico and then you will have to stay there a while until ready to travel. If you have a complication and this can happen, then you would have to travel back or have someone at home to take care of the problem. You need to be very close to your surgeon for postop care. Best to do is seeing a local surgeon to see if they can work something with you.

Some Medicaid plans do cover breast reduction, especially if you live in a state where you have a Medicaid HMO. The best thing to do is to call the member services phone number on the back of your insurance card and ask if CPT code 19318 which the code for a breast reduction is covered. If it is covered then you need to find out the exact criteria for coverage and see if you would qualify. You would also need to find a surgeon that accepts your specific Medicaid plan.