Are You a Candidate For Free Breast Reduction Covered by Insurance?
Did you know you can get your breast reduction surgery fully covered by insurance? Read on to discover more about it, and determine your chances for such an option.
Does Your Breast Size Matter?
Along with your symptoms, the size of your breasts in comparison to your body size might influence whether your insurance will pay for breast reduction surgery. Some health plans specify how much tissue must be removed for the surgery to be declared medically essential.
Some health plans utilize the Schnur Sliding Scale to determine medical necessity, but most experts believe it is outmoded, imprecise, and a poor predictor of symptom improvement. The Schnur approach relates the weight of the breast tissue that will be removed to a person's entire body surface area. Scores over the 22nd percentile are usually indicative of medical need, but those below the 5th percentile are deemed cosmetic. If your score falls in between these percentiles, your surgery may or may not be allowed.
How Much Weight Is Eliminated With a Breast Reduction?
The minimal weight that must be lost to qualify for surgery is determined by the size of your breasts and body. Some insurance plans consider the surgery cosmetic if it removes less than 200 g to 350 g (7 oz to 12 oz) of breast tissue. Other insurance companies demand that the planned removal weigh at least 500 g (approximately 18 oz) before an operation is judged medically essential.
Does Medicare Cover Breast Reduction?
Medicare supports free breast reduction surgery NJ that is medically required. This is true for both original Medicare and Medicare Advantage. For your operation to be covered, you must have problems caused by big breasts that have interfered with your daily activities for at least 6 months.
How Much Does a Breast Reduction With Insurance Cost?
Your insurance plan will determine your out-of-pocket payments for breast reduction surgery. Your cost-sharing responsibilities are stated in your summary of benefits and coverage (SBC), which contains information on any of:
It is crucial to know that you may receive many invoices for your operation, including those from your surgeon, the surgical facility, and the healthcare professional who gave your anesthetic.
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How Much Does a Breast Reduction Surgery Cost Without Insurance?
The cost of breast reduction surgery varies significantly. Without insurance, the cost might range from less than $5,000 to $19,000 or higher. MDsave, a healthcare price-shopping website, estimates the procedure's average cost in the United States at over $12,000. CareCredit, a healthcare finance provider, estimates an average cost of between $3,000 and $19,000.
Fees and Additional Charges
According to the American Society of Plastic Surgeons, the average surgeon price for a cosmetic breast reduction among its members is around $6,800. However, in addition to the surgeon's price, you may incur other fees associated with breast reduction surgery, such as:
It's worth noting that women over the age of 40 are normally required to furnish their surgeon with a recent mammogram prior to surgery. However, this can be a necessity regardless of age.
How Can I Finance a Breast Reduction Without Insurance?
If you do not have health insurance, here are some tips to make breast reduction surgery more affordable:
The bottom line
Health insurance covers breast reduction surgery when it is medically essential. Proving the medical necessity of your operation to your health plan can be difficult and requires evidence from your healthcare provider. However, acquiring insurance to cover your breast reduction can help you save a lot of money.