CAN WE TALK REDUCTION

I need some input ,,,Does anyone know what size you have to be to have a insurance pay breast reduction?  I am a 36 DDD on top and the rest of me is an 8 -10 .  My boobs are not the long sock typeLOL , sorry, but they are HUGE ,ROUND and weigh alot and by the end of the day I have back spasms , neck ones and dents in my shoulders.   I  am so sick of having these huge boobs and can only find bras that fit well that cost a fortune ..
HELP PLEASE and thanks so much
Shirl

Talk to your insurance carrier about their requirements. They would probably need medical necessity letter from your doctor but ask them.
Lana

Call your insurance company to find out exactly what their requirements are for your policy. They may have a specific amount of weight that will need to be removed. When you have a consult with a plastic surgeon you can ask if they feel you will meet the requirements.

I thought there was a standard amount /size for all insurance that someone had to be before they would do it .  I dont think each insurance companies have different rules on that do they ? AANyway was hoping for a quick answer as USUAL , LOL, as getting to see my PS is a wait and then you have to book a visit etc ..

If you are a DDD and have documented back, neck and shoulder symptoms, it should be covered as medically necessary.  You really do need to go to a consult with a plastic surgeon though and have them submit a pre-determination of benefits to your insurance.   I've worked in insurance for 19 years.  You still need them to approve it first though.  I am a 42DDD and I am considering going for a consult myself.  Good Luck with yours!!!

Thanks Kathy ,,,,I think I i will do the same ..

Many insurance companies use the "schnur Sliding Scale".  Please use the link below which I found on a bc/bs site.  Mine were a 36G LONG so they didn't have a lot of mass and I still fell within their guidelines.  Sounds like yours are heavy and have a lot of mass so you shouldn't have any trouble fitting within insurance guidelines.  Contact your particular insurance company and see what their guideliens are.  You may even be able to find that information online.  I had immediate relief from my back pain.

http://www.bcbst.com/MPManual/The_Schnur_Sliding_Scale_chart .htm

My insurance paid for my breast reduction and to be honest I wasn't as big as you are I was wearing about a 40 D but they were hanging and I had back pain all the time. I talked to nurses at the Dr. office and from the insurance company and I met the criteria. The Dr. did the reduction and lift at the same time and it's been about 2 months since surgery and I am wearing a size 38C or a 36D so I didn't really go down in size too much but they are definetly perkier and I don't even need to wear a bra which is a plus.  I love my new breasts now my tummy tuck is a whole other problem I'm not sure if I love it yet, but there is still alot of swelling and I really need to work out my stomach muscles.  I guess I was hoping for a miracle you know I just wanted to wake up with perky boobs and a six pack well at least I got the perky boobs. lol I hope that helps just ask the surgeon to try to get your insurance to cover the breast reduction.

Thanks so much for your reply..  I am going to talk to my Dr and see ..I am keeping my fingers crossed ..
Did it take while to recover?

I am scheduled for a reduction in 2 weeks and I am a size 40D. But I have documented neck & back issues as well as extremely saggy bewbies. My PCM sent in the referral and TriCare set me up with a PS and he assures me I will have no problems getting it covered. Matter of fact he must be sure as he gave me 3 scripts to be filled (which I was advised by the nurse to so asap) and said he would see me at 8 am on the 20th..

I would think most PS know what terminology to use to get you approved, after all they want you to have the op done as much as you do..lol

Good luck