Breast reduction for form and function
Your breast reduction,covered by insurance.
Understanding your options is the first step. Our practice manager offers a complimentary review of your insurance benefits—even if you do not yet know whether you have out-of-network benefits.
The breast reduction pathway
Three steps,
personal guidance
every step of the way.
Begin with your benefits. Move forward with an understanding of the clinical assessment and what each appointment means.
Understand your plan
Complimentary
benefits reviewOur practice manager reviews your individual insurance plan to determine whether it includes out-of-network benefits our practice can work with.
Anyone exploring this pathway may request a review.
An initial clinical assessment
Meet with
Leah Corredora, PA-CIf appropriate out-of-network benefits are confirmed, you will meet with our PA at no cost. She reviews your history and concerns and assesses whether you appear to be a candidate for medically necessary breast reduction.
Virtual or in person
Personalized surgical evaluation
Consultation with
Dr. SmithIf Leah’s assessment indicates that you may be a candidate for medically necessary breast reduction, you can meet with Dr. Smith at no cost to you through this pathway. He evaluates your surgical candidacy, discusses your options and develops an individualized plan.
Available when the preceding eligibility steps are met.
Plan-specific guidance
Can insurance cover
breast reduction?
Breast reduction is often covered by insurance when it is medically necessary. Your plan’s out-of-network benefits may help cover care with Dr. Smith, a board-certified plastic surgeon in Manhattan.
Our team helps you understand your benefits, gather the information your insurer needs and navigate the next steps toward covered care. We also explain potential patient costs so you can plan with confidence.
What your benefits review can clarify
- Out-of-network benefits
- Whether your individual plan includes benefits our practice can work with.
- Potential patient costs
- Deductibles, coinsurance and reimbursement limits for the proposed care.
- Documentation and authorization
- The information and review steps required by your plan.
- Separate services
- Surgeon, facility and anesthesia benefits, including remaining uncertainties.
Individualized breast reduction care
Comfort. Proportion.
Your personal goals.
Dr. Smith considers your anatomy, comfort and goals together. The conversation includes the shape and proportion you hope to achieve, your priorities and the timing that fits your life.
Changes in weight, future pregnancy and breastfeeding plans can inform that discussion. Surgical planning is individualized; a particular cup size or result is not guaranteed.
Choose the appropriate starting point
Which consultation
should I request?
The complimentary clinical appointments described here are limited to patients who meet the stated steps of this medically necessary breast reduction pathway.
Begin with the benefits review if you are exploring whether your insurance may help with breast reduction. The team will explain your findings and the appropriate next step.
Other cosmetic surgical consultations
General cosmetic surgical consultations with Dr. Smith remain $500.
View the existing standard consultation pageCommon questions
Clarity before
the next step.
How do I find out whether my insurance covers breast reduction?
Start with a review of your individual plan. Our practice manager can help clarify out-of-network benefits, plan requirements and remaining uncertainties. Clinical candidacy, insurance authorization and payment are separate decisions.
Can I request a review if I do not know whether I have out-of-network benefits?
Yes. Anyone exploring this pathway may request the complimentary administrative benefits review. You do not need to determine your own out-of-network benefits first.
Does the review mean surgery is covered?
No. The review does not establish medical necessity or guarantee insurance approval or payment. Your clinical team assesses appropriate care, and your insurer applies your plan’s rules.
What if appropriate out-of-network benefits are not identified?
The team will explain the finding and any available next steps. Complimentary clinical appointments under this pathway depend on the stated eligibility requirements.
Is surgery free?
No such promise is made. The conditional no-cost clinical appointments are separate from surgery and other services. The team explains expected patient costs for proposed care separately.
Your first step
Understand your options.
Begin with your benefits.
A confidential, complimentary review can help you understand whether your plan may work with this breast reduction pathway.