Getting breast reduction surgery covered by your insurance

Getting breast reduction surgery covered by your insurance

Many patients believe if a procedure is considered cosmetic, it is not a medically indicated and a covered procedure. It is usually not the case for breast reduction surgery. This procedure, also known as reduction mammaplasty, is indicated for the treatment of symptomatic macromastia (large breasts). The commonly reported symptoms related to large breasts are neck, shoulder and back pain caused by the weight of overly large breasts upon the musculoskeletal system. Other secondary symptoms can include breast pain and dermatitis or rashes beneath the breasts.

Majority of private medical providers in New Zealand, if you meet their specific criteria, will cover the entire or part of the cost of a breast reduction. Every insurance company will have different, independent criteria and indications hence it is important to check with the prior.

I usually write to my patient’s insurance provider which makes the process easier for my breast reduction patients.

From the 22nd of October 2024 Southern Cross members on some of the most popular plans benefit from an increase in cover up to $15,000 per lifetime for breast reduction surgery and an increase in breast symmetry cover to $10,000 per lifetime.  It is part cover, but I have noticed an increased number of Southern Cross members presenting for breast reduction surgery since then.

Breast reduction surgery is a life changing procedure and the most common one I perform in my practice, and I absolutely love doing it.