Is Breast Reduction Covered by Insurance If It’s Part of a Mommy Makeover?

Breast reduction is one of the few plastic surgery procedures eligible for insurance reimbursement. In many cases, the procedure is deemed medically necessary because oversized breasts cause chronic pain, bra strap grooves in the shoulders, rashes and other health problems. Insurance companies recognize that reducing the size of the breasts can significantly alleviate these health problems*.

You may wonder whether breast reduction is still eligible for insurance coverage if it is part of a mommy makeover. Dr. Joshua Greenwald clears up the confusion here.  

Mommy Makeover Pricing

First, let’s establish how mommy makeover is priced. Mommy makeover is a generic term for a combination of procedures women typically desire after having children. There is no one fixed price for a mommy makeover, or even a one-size-fits-all treatment plan. The cost can range from $5,000 to $20,000 or more, depending on the specific procedures performed. A mommy makeover that combines breast reduction with liposuction will be priced differently than a mommy makeover that combines breast lift with tummy tuck.

Insurance Companies May Cover the Cost of the Breast Reduction Portion

It would be unusual for an insurance company to cover the entire mommy makeover cost. However, qualified breast reduction candidates may receive reimbursement for part or all of that portion of the mommy makeover (and not the other procedures like liposuction).

Note that insurance companies usually have certain requirements that must be satisfied. For example, a certain amount of breast tissue (e.g., 500 grams or more) must be removed during the operation. The number is based on a special formula that considers the patient’s body surface area and weight.

Also, insurance companies generally require detailed documentation from a physician confirming that the patient’s breasts are causing health problems.

Financing Plastic Surgery

If your insurance company is covering the cost of your breast reduction but you need help covering the rest of your mommy makeover — or if your mommy makeover does not include breast reduction — you might be interested in your payment options.

Dr. Greenwald suggests you inquire with our practice about plastic surgery financing. Thanks to companies like CareCredit, you can split the cost of your mommy makeover into manageable monthly payments.

Call (914) 421-0113 or (212) 518-1642 or email us today to speak with one of our staff members about plastic surgery financing.

*Note: This information is for general purposes only and should not be regarded as fact. Please check with your insurance company for specific details about your plan coverage, restrictions and requirements.