It seems like a simple question. “Is breast reduction surgery covered by health insurance?” But the answer can be very complicated and involve many variables. It is typically considered a cosmetic procedure until the patient can show an adequate number of related health issues and attempted remediation prior to undergoing corrective surgery.
Once the threshold has been reached, the insurance company may then consider breast reduction a reconstructive procedure. The problem is that the threshold can be different for every insurance company reviewer.
Breast reduction surgery, also known as reduction mammaplasty, is a corrective treatment of symptomatic macromastia (large breasts). Symptoms related to macromastia are neck, shoulder and back pain and may include breast pain and dermatitis or rashes beneath the breasts.