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How do I start the process to see if my insurance will cover a breast reduction?

Patients who have very large breasts can have symptoms from the large breast with neck pain, back pain, shoulder pain, bra straps digging into their shoulders, inability to find bras or clothing that fit appropriately and difficulty exercising. They also may have yeast infections along the breast folds and have to use powders or topical ointments. When a patient has the above symptoms as well as findings on physical exam that support the macromastia or excessively large breasts, a breast reduction may be a procedure that is covered by insurance. Documentation of these issues is very important in sending information to the insurance company for pre-certification. If the patient has seen their family physician or ob-gyn about some of these issues, documentation in a letter of support from them definitely helps. If the patient has been to see a chiropractor for upper back, neck or shoulder pain, or has tried physical therapy and strengthening exercises without improvement, documentation of these endeavors would also help. At the time of the consultation we will review the symptoms or complaints that the patient has, the treatment that has been tried so far, do a physical examination with measurements, and discussed the pre-approval process with the insurance company.

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