Breast reduction cost without insurance?
September 11, 2011 5:43 PM   Subscribe

Does anyone have experience getting a breast reduction without insurance?

My partner wants to get a breast reduction. It is mainly for aesthetic/self-esteem purposes, as she identifies sort of butch/androgynous and her huge breasts don't fit her self-image. She also loves exercising and finds they get in the way/hurt during a lot of activities. She has some back pain also. She is in excellent shape and not overweight, but we are still unsure if a breast reduction would be covered in her case (even if she had insurance, which she doesn't, as she is currently freelancing.)

We are considering proceeding anyway. We'd probably take the money we'd be applying towards private health insurance and stick it aside for a year or so until we have the funds. However, I'm not really sure how much private insurance would cost us, nor how much the breast reduction would cost. And I'm not sure where to start.

If we go to a consultation with a surgeon before getting her health insurance (if we went that route), would this affect her chances of having the reduction covered?

Anyone else have experience with this? We are not looking for advice on whether or not she should have the surgery, only whether or not she should do it without insurance.

Thanks.
posted by ohsnapdragon to Health & Fitness (7 answers total) 2 users marked this as a favorite
 
I don't have this specific experience, but here in LA, I negotiate with lots of medical providers from dental to my dermatologist. Shop around, see if you can pay in installments, some Drs. might be open to barter (if you have skills that they can use) and you could also try to sell a freelance story based on her experience and/or results. I firmly believe that just about everything is negotiable.

RealSelf.com is probably the most legitimate cosmetic surgery forum site. I found my dermatologist here and I've been pleased with her.
posted by Ideefixe at 6:26 PM on September 11, 2011


Sounds like a bit of research would help you a lot, as far as discovering what insurance would cover, and how long of a wait might be expected in either case. It may turn out that paying for insurance costs you less in the long run? And it's a good idea to find out about wait times in your area, in both scenarios - you may be able to get waitlisted to take the place of someone who cancels. I had this done here in Canada (covered completely - yay!), and the mention of shoulder/back pain seems to set the ball rolling, as far as that goes, so make sure you mention that in any consultations, and maybe make the cosmetic issues secondary.
posted by fish tick at 7:18 PM on September 11, 2011


Best answer: Hi there, I had a breast reduction a year ago without the aid of an insurance company, even though I have insurance.

It's getting harder and harder to get breast reductions covered by insurance. Either you've got to be an extreme case or have documented proof of pain and problems that span a period of time. Some insurances require you to go through methods to prove that you've tried correcting the situation through physical therapy, weight loss, etc. I tried going the route of having insurance cover mine, but the hoops they wanted me to jump through were not worth it to me. Every insurance company differs in what they require.

The way I did it was I applied for Care Credit through Capital One which is basically a credit card for medical expenses (including cosmetic). I got approved for an amount that was about 3/4 of the cost of the reduction and then I put the rest on a credit card. It cost me $7600 for the surgery. It was $5000 (which covered all follow up appointments) for the surgeon and the rest went to the outpatient center fee and anesthesiologist. Having the surgery at the outpatient center as opposed to a hospital was much cheaper and since it's not a high risk surgery, it doesn't need to be done at a hospital. If your partner is in healthy shape and doesn't have any underlying problems that would make surgery more risky, have it done at an outpatient center.

I had to have three prescriptions filled. The ones for pain meds and antibiotics was absolutely necessary, but the anti nausea pills were pretty much useless and didn't even work.

Another expense you will have to factor in is that she isn't going to be able to work for a little bit depending on what she does. If I had a desk job, I could have gone back to work after about two weeks but since I work in a restaurant, I didn't work for about 5 weeks and I wish I would have been able to afford more time off. Even after I went back to work, I still couldn't do a lot of my job duties and was fortunate my coworkers were more than willing to help me do the things I couldn't do at work. At home, I was pretty much worthless for the first month and only did light, easy cleaning duties in the second month. Having a supportive and patient boyfriend helped tremendously.

Breast reductions are a pretty major surgery and recovery takes a long time but it was so worth it and the surgery will change your partner's life. If I knew then how much it would change my life now, I would pay twice the amount I spent just because it was it's that dramatic of a change in my enjoyment of all aspects of my life. I'm very open about my experience so if you want to memail me at any time, feel free. Breast Health Online is a great resource in everything boobs. Scroll down to the breast reduction section and you'll find a wealth of information. If you don't find your answers here on Metafilter, check out that board since the people there know the ins and outs of basically everything, including how to deal with insurance companies. Good luck to your partner!
posted by MaryDellamorte at 7:27 PM on September 11, 2011 [7 favorites]


Best answer: I just wanted to suggest that you not do this plan of using the money you would use for health insurance to pay for the breast reduction.

There are two major drawbacks to this strategy:
- Your partner won't have insurance to cover her if, god forbid, she gets sick and needs medical care, for example if she breaks her ankle or gets cancer or has a car accident. Even if she's otherwise completely healthy, you're always healthy until one day, you're not. And once you have pre-existing conditions, it becomes much more difficult to get health insurance at that point. Saying that you don't need medical insurance because you don't have health problems is faulty logic.

- If something happens during the surgery, you will not have the funds to pay for the additional care that will be required. Remember the cautionary tale of Kanye's mom who died getting cosmetic surgery. Just because surgery is cosmetic and elective doesn't mean that bad things can't happen and people can't die. Surgery has real risks including serious infections, blood clots, allergic reactions, airway problems.... Consider carefully whether taking those risks is worthwhile without insurance.

I suggest you instead make a targeted savings account or other bank account (with whatever the highest interest rate you can get is in the current market) and save up the money needed for the procedure in that account while keeping yourselves insured. Cut something out of your budget that you actually don't need.
posted by treehorn+bunny at 9:29 PM on September 11, 2011


Are you willing or able to travel overseas for the surgery?

A friend of mine had breast reduction and excess abdominal fat removed in a private hospital in Malaysia, and is very happy with the results. (Plus she got a two-week recovery vacation there!)

It wasn't particularly expensive as I recall, but the air fare might make the costs prohibitive for you. Memail me if you'd like more details.
posted by vickyverky at 8:29 AM on September 12, 2011


Best answer: I work for a plastic surgeon who does not take insurance so I don't have much to comment on that particular aspect, however, I wanted to respond to some of the comments here -- my main recommendation is to have your surgery in a hospital, with a board-certified plastic surgeon and a board-certified anesthesiologist. I tell all my potential patients that while I hope they book with us, whoever they go with should operate in a hospital. Really bad aesthetic results (as well as you know, death) occur much more frequently with in-office procedures. If something should happen to put your life in jeopardy during surgery, you want to be in the hospital, not waiting for an ambulance to take you there.

I highly urge you not to go overseas to have this done; same problems as above apply with the added bonus of a language barrier.

Recovery time varies widely; we generally recommend one week off of work and after three weeks you are cleared to resume normal activities (including exercising, cleaning, etc.)

CareCredit is a great resource that many of my patients take advantage of.

Make sure when you do go for consultations, you ask to see pictures of the surgeon's work ; check nipple placement, scarring, symmetry, etc.

The cost is between $7000-$9000 with my surgeon but that varies widely from place to place.

Memail if you like and best of luck to you!
posted by tatiana wishbone at 11:23 AM on September 12, 2011 [1 favorite]


Really bad aesthetic results (as well as you know, death) occur much more frequently with in-office procedures. If something should happen to put your life in jeopardy during surgery, you want to be in the hospital, not waiting for an ambulance to take you there.

No one suggested having the surgery done in an office, is that even possible? However, I did mention an outpatient center which is vastly different than an office.
posted by MaryDellamorte at 3:25 PM on September 12, 2011


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