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Will My Breast Reduction Be Covered By Health Insurance?

Nov 25, 2019 | Breast

Like all parts of the body, breasts come in many shapes and sizes. The effects of large or heavy breasts, however, cannot be underestimated. An increasing number of individuals suffer from issues such as back, neck, and shoulder pain, and even curvature of the spine. Patients also know how difficult oversized breasts can be when coping with exercise and physical activity. This can take a toll on the body and affect your quality of life.

Generally, patients think that only medically necessary procedures are covered by insurance. This means they may not seek breast reduction treatment because they are afraid of the cost. Board-certified plastic surgeon Dr. Jaime Schwartz performs breast reduction surgery as both a cosmetic and reconstructive procedure. Not only can we give women a more contoured silhouette, but we can also relieve some of your most problematic physical symptoms. This means your insurance company is more likely to cover a portion of the cost.

Dr. Jaime Schwartz is a recognized expert in plastic surgery. At our patient-first practice in Beverly Hills, CA, we offer breast reduction surgery in a comfortable and safe environment that gives you the functional and aesthetic results you want. Take the first steps and learn how your breast reduction may be covered by insurance.


Also called a reduction mammoplasty, breast reduction surgery helps patients with disproportionately large or sagging breasts. This surgery involves reducing fat and lifting the breasts to alleviate some of the weight and make you appear slimmer.  During your initial consultation, Dr. Schwartz will inform you about the options available for breast reduction, including his specialized LipoLift® technique.

Breast reduction should only be performed by a skilled, board-certified plastic surgeon. A LipoLift is more advanced than a typical breast reduction surgery as it is less invasive, allowing patients to have a faster recovery time. What makes this treatment unique is that it uses liposuction to reduce the size of the breasts. Liposuction makes the end result more precise and symmetrical. With this less complex procedure, patients also see a reduction in post-surgery complications such as swelling, bleeding, and infection.

LipoLift technology allows Dr. Schwartz to contour the breasts to the desired shape and size. In this next section, you can learn the answer to a common question: Does insurance cover breast reduction?


So, does insurance cover breast reduction? The first essential step is to take notes and carefully document any debilitating symptoms that may be related to your large breasts. When proper documentation and information are given to the insurance company, they are more likely to cover the costs. For instance, if you have frequent back pain, write down how long the pain occurs and how often. You should also note the intensity of the symptoms and whether they change or get worse over time. Other common health issues related to enlarged breasts:

  • Difficulty or inability to exercise
  • Numbness in the breast or chest area
  • Persistent pain in the joints, shoulders, neck, and back
  • Shortness of breath due to the weight of the breasts
  • Recurrent skin rashes and infections under the breasts
  • Painful shoulder grooves where the bra straps rest on the shoulders
  • Poor body image and low self-esteem

Insurance companies generally require 2 – 3 documented reports from other referred specialists before they'll consider covering breast reduction. Also, the insurance companies typically request 6 – 12 months of documentation and treatment by either a physical therapist, chiropractor, dermatologist, or orthopedist. If you have questions regarding medical documentation and breast reduction cost, feel free to contact a member of our professional staff.

Once we have decided you are an ideal candidate for surgery, Dr. Schwartz and his Beverly Hills team will work with you to understand your individual plastic surgery insurance coverage and overall breast reduction cost. Every insurance company has different criteria, so not every patient will get the same answer. If the insurance company does not approve coverage at first, do not lose hope! Our staff will guide you through the process so you can get the treatment you need in an affordable manner.


The issue of insurance for breast reduction surgery does not have to be complicated. When it comes to feeling better and improving your natural shape and silhouette, Dr. Jaime Schwartz offers the latest in breast reduction techniques with the highest standards of patient safety in mind. If you are wondering how to get a breast reduction covered by insurance, start by scheduling a consultation at our facility in Beverly Hills, CA. Once you are approved by your insurance carrier, Dr. Schwartz can schedule your breast reduction surgery. We can also discuss our easy financing options during your consultation. Your journey to smaller breasts and less discomfort starts with a phone call to our Beverly Hills office.



Beverly Hills Office

240 South La Cienega Boulevard
Suite 200
Beverly Hills, CA 90211

Phone: 310-882-5454