# will breast reduction surgery be covered by Vivas?



## <kat> (2 Mar 2008)

Hi,
New memeber to this site. Been reading through the forums and thought id post my question in the hope that somebody can give me some info. 

Im at the very begining of the process of undergoing a breast reduction. I am going to my GP with back shoulder and neck pain on mon. This is an ongoing problem but recently has gotten worse. I am going to ask my GP for a referral to a PS but before I do I want to know if it would be covered by Vivas health if it was done as a medical reason? 

I haven't contacted Vivas health yet as i need a procedure code from a PS to see if its covered and i haven't gotten that far yet. 

If its not covered Ill have to hold off for awhile as I dont have the funds to go private at present. 

Thank you in advance for any replies!

(I am not seeking any medical advice as I read in one of the guidelines that this is not allowed!)


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## scuby (2 Mar 2008)

*Re: will this surgery be covered by vivas?*

usually this procedure would be covered once not there is a medical reason to have it done, ie cosmetic. as far as i know there would be certain criteria where it would be covered, and the PS would know them and would have a good idea if it would be approved, as i sure he would have done this before...


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## sorting it! (2 Mar 2008)

hi, two friends of mine had this surgery done in ireland. Both  were covered under health insurance as it was medical reasons they had it done for. Im not sure who the insurance company was though. Maybe your GP would have some info for you as s/he might have another patient gone/going through the same surgery. If you aren't covered by vivas then i think its approx €6000 to have done privately. Varies between clinics. Im not sure how the public system would work for this but can imagine the waiting list would be endless!
Best of luck!


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## NuMarvel (2 Mar 2008)

Well, it seems to be listed in their Listed of General Procedures on their website - [broken link removed]. It's on page 34 (numbered as Page 33). If you do a search in the document for Breast Reduction, this is what comes up.

It says it requires pre-certification unless it's for reconstruction following a mastectomy, so your doctor/consultant will probably have to send them something before you know for definite whether it's covered or not.

It's probably no harm calling VIVAS anyway, because they can check if waiting periods are served/applicable, what kind of hopsital cover you're entitlted to, is your consultant recognised, etc.

In any case, best of luck with the procecdure!


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## <kat> (3 Mar 2008)

I actually missed this!! I searched throu that list but by the time i got to that page i must have skimmed over it!!!


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## Madilla (3 Mar 2008)

I enquired about this with Vivas last year and below is the e-mail reply I received from them. I too suffer from neck and back pain and have discussed this with my doctor who thinks I should be covered. She advised me to try this route first but also told me that she has had a number of public patients who have had the procedure carried out under the public system so if I could pursue this if Vivas do not cover it. I got the appointment before Christmas but had to wait until May for a consultation date.


Thank you for your e-mail.



I can confirm that VIVAS Health do cover this procedure. The following criteria must all be met in 

order for this procedure to be covered,



1.                  BMI < 27 

2.                  Bra cup size >/=F

3.                  Symptoms:

(a)   Back pain, either thoracic or cervical, that has persisted for at least a continuous three month period and has been severe enough to require daily use of prescription analgesia for at least four weeks.

(b)   Acromio-clavicular syndrome


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## NuMarvel (5 Mar 2008)

<kat> said:


> I actually missed this!! I searched throu that list but by the time i got to that page i must have skimmed over it!!!


 
"Ctrl" and "F" - My best friends, ever!


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## <kat> (6 Mar 2008)

thank you for posting the email response. well i qualify under all except not sure about 3(b). must find out what that means!!!  mustn't have it if i never heard of it unless doc was using lay mans terms!!! 
thought they'd have fairly strict criteria alright.


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