Boob jobs under medicare

Breast reduction surgery, or reduction mammaplasty, is a type of plastic surgery that involves the removal of excessive amounts of breast tissue, skin, and fat, resulting in the reduction of breast size. Breast reduction surgery may help relieve some health issues, such as chronic back and neck pain, rashes and skin chafing underneath the breasts. Every year in the United States, well over , breast reduction surgeries are performed. Some women choose to have the surgery for cosmetic reasons, but most women opt for breast reduction to relieve their health issues. This amount varies greatly depending on the location, the cost of the facility, surgeon and anesthetist fees, tests required, prescriptions, as well as the length of stay and after-care. If your physician has suggested breast reduction surgery to relieve your related health issues, it is important to have all the details of whether your surgery is covered by Medicare or Medicaid.

Prior to receiving a medical service or procedure, you may be required to obtain approval from your health insurance plan. While your provider may also do this on your behalf, keep in mind that it is your responsibility to ensure preauthorization is obtained from Independent Health prior to receiving these services to avoid potential financial penalties. Independent Health will review the member preauthorization request, which may take 3 to 5 business days. Once a decision is made, you will be notified in writing of the decision.

In addition, Medicare covers breast reconstruction, while Medicaid coverage can vary from state to state. Government- and church-sponsored plans are not necessarily required to cover reconstruction, so you may need to check with your plan administrator. Another potential resource is your state health insurance agency and commissioner, as some states have passed additional laws requiring coverage for breast reconstruction.

These are a list of clinical criteria that have explicit coverage for breast augmentation for transgender women. Policy Issued By: Aetna. Policy Title: Gender Affirming Surgery. Note: More than one breast augmentation is considered not medically necessary.