Women who want to renew their breasts and achieve a perky, youthful appearance often want to know whether insurance will cover a breast lift procedure. The answer to this common question depends on various factors.
When it comes to surgeries, every insurance company individually determines which procedures they will or will not cover. The most key factor considered by insurance companies is whether or not the surgery is cosmetic in nature or reconstructive, which may be considered medically necessary.
How does the AMA distinguish between cosmetic and reconstructive surgery?
According to the AMA (American Medical Association) defines reconstructive surgery as follows:
Procedures performed to correct trauma, developmental defects, infection, or disease. Reconstructive procedures focus on improving function or normalizing the appearance of the patient.
The AMA defines cosmetic surgery as follows:
Procedures that are focused on improving the aesthetic appearance of the face or body to improve a patient’s appearance or self-esteem.
Do insurance companies always follow the same definitions of cosmetic and reconstruction surgery as the AMA?
Not always. Many insurance companies interpret the definitions in different ways, depending on the situation and what the procedure is. Dr. Alizadeh can help counsel you on the potential for insurance coverage, but in order to know for sure, about weather your breast lift could possibly be covered, you would need to contact your insurance provider to discuss how your procedure will be classified and whether it’s likely to be covered.
Is breast lift surgery considered cosmetic or reconstructive?
Generally, breast lift surgery is considered cosmetic, meaning it is unlikely to be covered by medical insurance. To get breast lift surgery approved as a covered procedure by insurance, you would have to prove the procedure is a medical necessity.
Breast reduction, which, like a breast lift, is a common procedure, has been covered by insurance in some cases.
How can you prove your plastic surgery procedure is medically necessary?
To get your procedure approved as a surgery covered by insurance, you will need to prove that there are health issues connected to your concern. This will include attempted remediations, documented reports from specialists, and sometimes 6-12 months of documentation and treatment by a specialist, physical therapist, or other doctor, such as a chiropractor or orthopedist.
Your breast lift with Dr. Alizadeh
Dr. Alizadeh developed a specialized, advanced breast lift procedure to improve results and lasting effects and minimize scarring. His specialized breast lift, called the NaturaBra™ surgical technique, creates an internal bra using the patient's own tissue, beautifully lifting the breasts for results that truly last.
Dr. Kaveh Alizadeh is a fellowship-trained, board-certified plastic surgeon with over 23 years of experience. He is the Founder and Medical Director of Cosmoplastic Surgery and an Associate Professor of Surgery at New York Medical College. Dr. Alizadeh served as the former Chief of Plastic and Reconstructive Surgery at Westchester Medical Center.
Dr. Alizadeh’s breakthrough NaturaBra™ Breast Lift technique puts him at the forefront of breast lift procedures. He is an authority on the breast lifts and other plastic surgery techniques.