Does Insurance Cover the Breast Lift Procedure?

A breast lift is a medical procedure that alters the shape and size of one’s breasts. These procedures can be incredibly affirming and are widely popular among plastic surgery patients. However, because the vast majority of breast lifts are not considered medically necessary, it can be difficult to get these procedures covered by your insurance policy. Knowing the cases in which insurance will cover a breast lift can help you determine whether you want to pursue the treatment. If you are considering getting a breast lift, read this guide, which answers the question, “Does insurance cover the breast lift procedure?”.

What Is a Breast Lift Procedure?

A breast lift is a cosmetic procedure that changes the shape and size of one’s breasts for either aesthetic or medical reasons. A breast lift is one of the most popular plastic surgery operations and has the potential to completely revamp a patient’s appearance.

Reasons for Receiving a Breast Lift

There are many reasons that an individual might decide to receive a breast lift. Some of the more common reasons individuals seek out this treatment include:

• Adjusting the breasts after pregnancy
• Adjusting the breasts after weight loss
• Simple aging
• Cosmetic repair after treating breast cancer

Most patients who are interested in receiving a breast lift will qualify. Still, you can discuss your eligibility for the procedure with your physician in a consultation prior to receiving any work.

Does Insurance Cover the Breast Lift Procedure?

In most cases, insurance companies will not decide to cover the breast lift procedure because breast lifts are not typically considered medically necessary. Instead, they are usually classified as cosmetic procedures. Still, many different factors influence an insurance provider’s decision to cover the cost of breast insurance. Sometimes, an insurer will decide to cover a procedure if the patient and physician are able to prove the medical necessity of the procedure. For instance, your insurance may cover a breast lift if you have severe ptosis of the breasts that leads to pain in the back, neck, or shoulders.

If you can get your physician or provider to write a note of medical necessity for your procedure, your chances of having insurance cover it will increase significantly.

Steps to Getting Your Procedure Covered

There are steps you can take to attempt to prove the medical necessity of your procedure and to have the cost covered by insurance. The following can assist you in proving to an insurance provider that you should have your breast lift procedure covered:

• Receive a medical necessity letter from your physician
• Gather evidence of medical necessity in the form of photographs and other documents
• Submit a pre-authorization request from your insurance company
• Follow up with your insurance company while they deliberate
• Consider appealing if your initial request is denied

Thoroughly documenting the evidence you need to prove medical necessity can be a challenging but not impossible process. Your physician should be able to help you strategize ways to have your procedure covered. Follow their advice to simplify this complex process.

Other Financing Options for a Breast Lift

There are other ways to finance your breast lift outside of having insurance cover it. Some of the common ways to do this include:

• Credit: Many patients turn to credit cards to pay for their breast lift procedures. Keep the interest rates of such cards in mind when considering this option so you do not find yourself in financial trouble.
•  Personal Loans: Many patients finance their procedures by procuring a personal loan from a bank.
•  Specialty Financing: Certain specialty financing programs cater to supplying funds for individual medical procedures. You may benefit from researching such programs.

All said, if you can convince an insurance provider that your breast lift procedure is medically necessary, you will save enormous amounts of time and money. Even if you doubt the likelihood of your insurance provider covering a breast lift, take the time to request coverage from your insurance provider. At worst, you can still pay for the procedure yourself, and at best, you will have saved yourself from a potentially immense financial burden.

The Best Choice in Southern California

Dr. Brent is a board-certified plastic surgeon operating out of Santa Barbara and Beverly Hills. If you are considering a breast lift and want to discuss it with an esteemed professional, contact Dr. Brent today.