Many people are surprised to learn that breast reduction surgery is often considered medically necessary and can be covered by insurance. While cosmetic procedures aren’t typically covered by insurance, breast reductions can alleviate chronic pain, posture issues, and skin irritation, making them a reconstructive procedure with meaningful health benefits. The added bonus? Patients also experience an improved silhouette and a better fit in clothing, which enhances both comfort and aesthetic confidence.
Insurance Can Cover Breast Reductions!
Dr. Frank Lalezar is a board-certified plastic surgeon in New York City who performs breast reduction surgeries with both functional relief and aesthetic balance in mind. He works with many patients whose insurance plans offer out-of-network benefits, making this procedure more accessible. If you’re experiencing discomfort due to large breasts, Dr. Lalezar and his team can help determine your eligibility and guide you through the process of seeking coverage.
Contact Dr. Lalezar’s Office to Explore Your Options
If you’re considering breast reduction surgery, the first step is scheduling a consultation with a skilled, board-certified plastic surgeon. Dr. Frank Lalezar combines surgical expertise with an artistic eye to deliver results that relieve discomfort and enhance your natural shape. During your consultation, Dr. Lalezar will listen to your concerns, evaluate your symptoms, and help determine if your procedure may be covered by insurance. Take the first step toward relief by contacting Dr. Lalezar’s NYC office to schedule your consultation.
We Work With Several Insurance Companies
Dr. Frank Lalezar works with out-of-network benefits from a wide range of insurance providers to help make breast reduction surgery more accessible to those who need it.
Many of his patients are able to use their insurance benefits to cover part or all of their breast reduction procedure, depending on medical necessity and plan coverage.
We work with the following insurance companies:
- Aetna
- Blue Cross/Blue Shield
- Cigna
- Emblem PPO
- Magnacare
- NYSHIP
- Oxford
- United Healthcare
If your insurance company isn’t listed, call our office to find out whether your provider offers out-of-network benefits that could apply to breast reduction surgery.
Breast Reduction Insurance FAQs
What does “out-of-network” mean?
Out-of-network means the provider is not contracted with your insurance company. However, many insurance plans still offer benefits for out-of-network care. That means you can still see Dr. Lalezar and potentially receive partial reimbursement for your breast reduction, depending on your plan. To check your eligibility, review your benefits booklet, call the number on the back of your insurance card, or ask your HR representative.
Can I change my insurance if I don’t have out-of-network benefits?
Yes, in many cases you can switch to a plan that better fits your needs. If your current policy doesn’t offer out-of-network benefits and you’re interested in breast reduction surgery, speak with the person who enrolled you in your plan. They can help you explore options and tell you when you might be eligible to make a change.
How long does insurance approval take?
Once we submit your request, the insurance review process usually takes 4 to 6 weeks. If your claim is initially denied, don’t worry—Dr. Lalezar’s team will file appeals and request peer-to-peer reviews as needed. You won’t need to take any action during that time unless we contact you. Once a final decision is made, we’ll reach out to schedule your surgery.
What kind of documentation is needed?
To support your claim, we’ll ask for records of symptoms like back, neck, or shoulder pain; skin irritation; and failed conservative treatments. We may also request letters from other healthcare providers or specialists. Dr. Lalezar’s office will guide you through gathering everything required to build a strong case for insurance coverage.
