Has Anyone Got a Breast Lift Covered by Insurance?

  After a major weight loss, I've maintained my weight for a little over a year.

I'm not one to know a lot about surgical procedures and insurance policies. So I walked into a plastic surgeons office about a month ago with the expectation of insurance covering the removal of my excess skin on my stomach, and a breast lift. 

I was told by the surgeon that he will gladly help me try with the stomach surgery as he believes mine is medically necessary, but that breasts lifts are NEVER covered for any reason and that he wasn't going to waste his time trying with that. I even desperately tried to explain the amount of problems I have with my breasts being the way they are. 

He sat and talked with me for a very long time, explaining how difficult insurance companies are, and how they never like to cover anything, and that they might even deny the paniculectomy the first time. I had never realized it would be this difficult. I ended up in tears and was very embarrassed.  

I get a lot of rashes below my apron of skin, AS WELL as under my breasts because they are very saggy. My breasts have always been saggy, but it has become 10 times worse since losing 140 pounds. I get rashes, infections, boils, acne, open sores, under my breasts. You name it, I get it. The skin has a lot of break down and hurts me all of the time. The entire skin under my breasts are completely full of scars from these issues. I literally have a 3-4 year history with doctors for the skin problems under my breasts. I am only a C cup though, so I don't qualify for a breast reduction, I wouldn't want one anyways. I wanted them lifted so they wouldn't rub against my skin and continue to give me issues.

I'm having the same skin issues with my stomach as my breasts, but they will cover one, but not the other. This doesn't make sense to me. I find them both medically necessary. 

Do you think I have hope in getting insurance to cover my breast lift if I continue to convince them of my issues? Or is this just a lost cause for me?

Are you in Canada? In the United States insurance is based on the company you have. In Ontario for example, it's based on OHIP. My panni was covered by OHIP and I upgraded to a full tummy tuck and paid out of pocket for that. Breast lift would not have been covered for me, but that doesn't mean it won't be for you.

Again, it depends on several things. Number one being a surgeon willing to submit to your insurance.

Annette 

My surgeon explained that insurance companies will sometimes pay for a reduction, but that requires a minimum amount of tissue removed. When it is simply a lift, it is only skin and that does not weigh enough to be covered. If there are rashes or infections involved with the excess skin, get your doctor to document that and perhaps you can use that to fight your case. Good luck.

Find a new doctor and consult with him, doctors should be sharing with you what they can do, how they can do it, and you should be

discussing Insurance and getting it covered with whomever handles Insurance billing.

Plus, you should be contacting your insurance company on your own, and finding out what needs submitted and how to help yourself

Get friendly with your insurance company, and educate yourself......That is what I am doing now......Best of Luck to you Always

Lynne

It does not hurt to try and get this covered especially with the dermatogical problems that you have experienced. It make take a long time but worth it to lower your costs!