Dr. Laura Mitchell
Board-Certified Plastic Surgeon, MD, FACS
Most purely cosmetic procedures are not covered by insurance. However, several procedures have medical indications that may qualify for coverage: Breast reduction—commonly covered when you have documented back/neck pain, nerve symptoms, skin rashes, and have tried conservative treatments. Your surgeon needs to document the medical necessity and the amount of tissue to be removed. Rhinoplasty/septoplasty—covered when there's a functional breathing problem (deviated septum). The cosmetic component is not covered but can be combined with the functional repair. Upper blepharoplasty—covered when excess skin obstructs your visual field (documented by visual field testing). Panniculectomy—covered when excess skin causes hygiene issues, infections, or mobility problems (distinct from cosmetic tummy tuck). For your breast reduction: start by documenting your symptoms with your primary care doctor, try conservative treatments (physical therapy, supportive bras), and get your surgeon to submit a pre-authorization with clinical documentation. Approval rates vary by insurance company, but breast reduction has one of the highest approval rates of any reconstructive procedure.