Breast Reduction: HSA Eligibility

For treatment of a medical condition, breast reduction is an eligible expense with a Letter of Medical Necessity (LMN) from a physician with flexible spending account (FSA), health savings account (HSA) or a health reimbursement arrangement (HRA). Breast reduction reimbursement is not eligible with a limited care flexible spending account (LCFSA) or a dependent care flexible spending account (DCFSA).

What is breast reduction surgery?

Breast reduction surgery is designed for individuals with disproportionately large breasts to solve issues related to both self-image and legitimate medical issues. For instance, some individuals may suffer from poor self-image related to their large breasts, or may experience difficulty fitting into bras and clothing, in which case the surgery would be primarily for cosmetic purposes. However, if patients are dealing with chronic pain issues, sleep problems other issues that are related to a medical issue, they would be eligible for reimbursement with a Letter of Medical Necessity (LMN).

It's important to note that while the vast majority of breast reduction surgeries are performed on women, men can also consider this procedure. For instance, men who have a condition known as gynecomastia, or abnormally enlarged breasts, may consider a breast reduction surgery to alleviate the issue. These surgeries require a pre-operative consultation with a plastic surgeon to go over the patient's past medical history, family history and what physical/mental/medical conditions preclude the need for a breast reduction.

How is breast reduction surgery performed?

Breast reduction surgery is typically done under general anesthesia in a hospital or outpatient surgical facility, and surgical techniques will vary based upon how much excess fat, tissue and skin will need to be removed. After administering anesthesia, the doctor will make an incision around the areola and down the breast and begin to remove excess material. Depending on how invasive the procedure may be, the nipple may need to be repositioned through the use of a skin graft.

After the surgery, the breasts will be wrapped in gauze, as well as additional bandages/dressings, and doctors may prescribe an antibiotic to prevent infections and encourage patients to start a regimen with over-the-counter (OTC) pain relievers to counter post-operation discomfort. The breasts may also feel tender and sensitive in the weeks following the surgery, which is why many patients opt for compression bras to control swelling, bruising and promoting the healing process. All told, most patients will need about a month free of physical activity during recovery, as well as follow-up appointments with their surgeons for the removal of stitches/bandages and further consultation.

Eligibility Table

Flexible Spending Account (FSA) Limited Care FSA Dependent Care FSA Health Savings Account (HSA) Health Reimbursement Account (HRA)

Eligible

Eligible with Rx

Eligible with LMN

Not Eligible

 


AZ-PROD-WEB01 11/20/2017 3:41:48 PM