Affinity health insurance
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If the first request is denied, demand an appeal.ġ0) If there is no insurance, and you cannot afford to pay a private surgeon, go to the plastic surgery clinic of a teaching hospital. You will be unhappy with tiny breasts.Ħ) Your surgeon needs to request pre-certification IN WRITING, and attach as much evidence as possible.ħ) Evidence includes letters from your internist, orthopedic surgeon, and/or chiropractor stating that breast reduction will relieve your symptoms.Ĩ) Some companies require that you try "alternative treatments" such as weight loss and physical therapy first.ĩ) Don't give up. Find out the details of your policy.ĥ) DON'T get too much of a reduction just to satisfy the insurance company. So that if you are tiny, smaller reductions will be covered. Even small breast reductions relieve many symptoms such as back pain and shoulder pain, and even some types of headaches.Ģ) Very big reductions (like from an F cup to a C cup) will usually be covered.ģ) Many policies will pay for breast reduction if 500 grams (a little more than a pound) or more are removed from each breast.Ĥ) Some policies take your height and weight into account.
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Here are some helpful points.ġ) Insurance companies try very hard not to pay for breast reduction, even though they should. Good luck!Ĩ0% of breast reduction questions on RealSelf are about insurance coverage. H i, I hope you find this article useful. This procedure is commonly covered by insurance through insurance criteria are becoming more and more restrictive Each insurance policy has different guidelines and exclusions. Pre-authorization by the insurance company is required prior to surgery, and the process takes approximately one month.
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Other problems which are less likely to be covered by insurance include skin irritation, skeletal deformity, breathing problems, psychological/emotional problems, and interference with normal daily activities. These problems may include neck pain, back or shoulder pain, hygiene difficulty, and breast pain. In general when the excessive breast size causes functional problems, insurance will generally pay for the operation if more than 400 – 500 grams are removed from each breast dependent on your individual insurance company requirements. Large breasts (macromastia) or breast hypertrophy can occur in a variety of conditions (family trait, post pregnancy, excessive adolescent growth). Unfortunately, each insurance company has their own criteria.