Does Medicaid Cover Breast Reduction?

Does Medicaid Cover Breast Reduction?

It is common for women to feel uncomfortable with the size of their breasts and require a solution to help with that.

When it comes to breasts which are too large, some women require a reduction and this is not only because of the way they appear but for their health and wellbeing too.

In this article, we will be speaking about medicaid and answering the question, ‘does Medicaid cover breast reduction?’.

What Is Medicaid?

Medicaid is a programme run in the United States to help people receive the medical care they need.

The programme works to help with costs which need to be paid for procedures as well as offering other benefits such as personal care services.

This is a great service for those unable to support themselves medically and for those with a low income.

Does Medicaid Cover Breast Reduction?

Medicaid may cover breast reduction surgery however this is not always set in stone.

Whilst many people need a breast reduction due to medical reasons, Medicaid will first require you to try to help yourself before turning to them.

Some self-treatments which can help with reducing the fat tissue in the breast is exercising, dieting or physical therapy.

Reasons To Have Breast Reduction?

There are several reasons why a woman would want to have a breast reduction. Some of these include:

Back Pain

If a woman’s breasts are too large, this can create immense back pain.

Breasts are fatty tissue and this is a big weight for a woman to carry, especially if this woman is petite.

In order to stop this pain, breast reduction surgery is a good option to provide relief.

Breast Cancer

Some women who have had breast cancer find that their breasts do not look like they used to after treatment.

As mentioned above, breast tissue is made up of fatty cells so when a woman has been treated for breast cancer, she could experience an increase in her breast size.

If this happens, then a breast reduction might be required.

Painful Nipples

Some women suffer from painful nipples. This can cause discomfort and make breastfeeding difficult.

A breast reduction can help to reduce the amount of fat around the nipple area and therefore reduce any discomfort caused by this.

Sagging Skin

Another reason to consider having a breast reduction is sagging skin.

Sagging skin can occur naturally over time but it is more likely to happen if a woman has gained a lot of weight.

Once again, breast reduction surgery can help to remove excess fat and give your breasts a better shape.

How Does Medicaid Cover Breast Reduction Surgery?

How Does Medicaid Cover Breast Reduction Surgery?

In most cases, Medicaid will pay for breast reduction surgery provided that the following requirements are met:

  • The patient must meet certain criteria including being under age 65, having a BMI less than 35, and having an annual income below $10,000.
  • The procedure needs to be covered by Medicare Part B (the part of Medicare that covers physician fees)
  • The surgeon performing the operation must be board certified.
  • The hospital where the operation takes place must be accredited by the Joint Commission on Accreditation of Healthcare Organizations.
  • The patient must sign a waiver form indicating that he/she understands the risks involved in the procedure and agrees to proceed with the surgery.
  • You should also know that Medicaid does not cover cosmetic surgery unless the doctor performing the surgery is board certified.

What Are the Risks Associated With Breast Reduction Surgery?

A number of complications can arise during breast reduction surgery so it is important to acknowledge these risks before making an informed decision.

These include bleeding, infection, nerve damage, scarring, and death.

The risk of each complication varies depending on the individual. However, some common complications include:

  • Bleeding – Bleeding is one of the most common complications associated with breast reduction surgery. It occurs because the blood vessels close to the incision site are damaged during the procedure.
  • Nerve Damage – During breast reduction surgery, nerves may be cut or bruised which can lead to numbness or tingling.
  • Infection – There is always a chance of developing an infection after breast reduction surgery. To avoid this, you should try to keep yourself well hydrated and use antibiotics as prescribed.
  • Scarring – Scarring is another potential problem that can occur after breast reduction surgery. In fact, scars are often present even after the initial healing period. They can become unsightly and uncomfortable over time.
  • Death – If there is excessive bleeding during the procedure then the risk of death increases. Other possible causes of death include heart attack, stroke, pulmonary embolism, sepsis, and other conditions related to anesthesia.

If you have any concerns about the risks associated with breast reduction surgery, you should consult with your doctor.

He/she will be able to discuss all aspects of the procedure and answer any questions you might have.

You should also make sure that you understand the risks associated with the surgery before proceeding.

Is Breast Reduction Surgery Safe?

Breast reduction surgery is generally considered safe when performed by a qualified plastic surgeon.

However, there are still some risks associated with the procedure.

For example, if the patient has had previous breast surgeries, she runs the risk of experiencing complications such as capsular contracture.

This condition results from scar tissue forming around the implant.

How Long Does Breast Reduction Take?

Breast reduction usually lasts between three to six hours. Most patients report feeling no pain at all during the procedure.

However, some women feel moderate discomfort while their breasts are being reduced.

After the surgery, you may experience swelling and bruising for several days.

Your doctor will provide you with specific instructions regarding how long you need to wear a compression garment.

This helps prevent swelling and promotes faster recovery.

Final Thoughts

Breast reduction is a very effective way to reduce the size of large breasts.

As mentioned above, the main reason women desire this surgery is for the sake of their health, and that is why they turn to Medicaid.

Medicaid is always there to help but in terms of breast reduction, the programme will want the patient to try to reduce their breasts for themselves- this is very possible.

However, this should not bring a person down. For more on breast reduction surgery with Medicaid, speak to your doctor.

Frequently Asked Questions

What is the weight requirement for breast reduction?

The weight of tissue to be removed – insurance companies will also rely on the amount of tissue to be removed from each breast to determine whether or not the reduction patient qualifies for coverage. Depending on the company, this weight requirement may be 450 grams, 500, or even 600 grams.

Does Medicare pay for breast?

Medicare usually doesn’t cover cosmetic surgery unless you need it because of accidental injury or to improve the function of a malformed body part. Medicare covers breast prostheses for breast reconstruction if you had a mastectomy because of breast cancer.

What do breast reduction scars look like?

Breast reduction scars vary in shape and size but usually look like a line that’s a lighter or darker shade than your natural skin tone. Scars can also be pink, red, purple, gray or dark brown. Some people are more at risk of developing raised scars. Scars can itch or feel tender after your surgery.