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Most plastic surgery procedures that change the size of the breast are not covered by insurance. These are considered elective, cosmetic procedures and most are paid out-of-pocket by the patient. There is an exception to this rule – medically necessary breast reduction surgery. This is one of the few breast plastic surgery procedures that can be covered by healthcare insurance, but it does require jumping through some hoops to meet the criteria.

What Is Medically Necessary Breast Reduction?

Large breasts are a common cause of pain. The heavy weight placed on the chest can strain the back and musculoskeletal system. Bra straps can put pressure on the shoulders and may result in nerve and other types of pain. Women living with chronic pain due to their breast size may be able to get relief with a breast reduction surgery. The goal is to prove that is it a medically necessary procedure, not a cosmetic concern.

Most insurance companies will want documented proof that chronic pain and other health concerns are due to the large breasts of the patient. This can include proof of multiple visits to address back or shoulder pain. X-rays and other imaging may be required. Some insurance companies will insist on patients trying other treatments to relieve their pain before they will approve a medically necessary breast reduction surgery.

Benefits of Breast Reduction Surgery

It can take months or more to meet the requirements of your insurance policy to cover medically necessary breast reduction, but for many women, it is worth the effort. Removing the extra weight from the chest can provide relief from pain suffered for years and years. Not only does it offer pain relief, but there are other benefits. Reducing the strain on the spine and back can reduce risk of degenerative issues and future spine problems. There are also cosmetic side benefits that many women enjoy, such as better fitting clothes.

If you have lived with the pain of large breasts for too long, come see us at Caliber Pain. We can evaluate your pain condition caused by your larger breasts and begin the process of seeking a medically necessary breast reduction surgery that is covered by your insurance. Call our medical center in NYC to schedule your exam and consultation.

Posted on behalf of Caliber Pain™

460 Park Ave, 8th Floor
New York, NY 10022

Phone: (212) 203-5987


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Caliber Pain™

460 Park Ave, 8th Floor
New York, NY 10022


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(212) 203-5987
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