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How to Get Gynecomastia Surgery Covered by Insurance

How To Get Gynecomastia Surgery Covered By Insurance

Gynecomastia is a common condition among males, in which there is excess skin and glandular breast tissue around the pectoral region of the chest. This excess skin and tissue is often unpleasant for men who would prefer a more masculine physique. Gynecomastia surgery in New Jersey can correct this issue by excising the excess glandular tissue and skin and removing fat via liposuction.

The procedure can produce outstanding results for male patients. However, for some men, financing gynecomastia surgery can be an issue. In this vein, many men want to know how to get gynecomastia surgery covered by insurance.

Below, we’ll outline the average cost of gynecomastia surgery and whether insurance coverage is something gynecomastia procedure patients can count on.

How Much Does Gynecomastia Surgery Cost?

It can often be useful to break down the cost of gynecomastia surgery so that you can actually see where your money is going if you decide to undergo this procedure.

Here are the main costs that will be included in your gynecomastia bill.

Gyno surgery covered by insuranceConsultation Appointment

Before you can actually get in the door and schedule your gynecomastia treatment, you need to book a consultation appointment. Your surgeon will need to determine whether you have man chest fat vs gynecomastia.

Because sometimes, patients will not follow through and schedule a surgery after their consultation, most plastic surgeons charge a unique fee for the work and time they put into this appointment. Often, the fee will go toward the cost of surgery if the patient decides to move forward.


The price of anesthesia is another component of your gynecomastia surgery cost. You’re paying for anesthesia in relation to the specific scope of your surgery. So, if you have a small gynecomastia case and only require light local anesthesia, this cost will be lower than if you have a more severe case and require general anesthesia.

Surgeon’s Fee

This fee is simply how much your surgeon charges for their treatment and care. It is, of course, your surgeon who will be orchestrating and performing your procedure, as well as managing your aftercare.

Surgeon’s fees vary depending on the level of expertise and experience a surgeon has, where they are located geographically, and how much work is required for their services.

Post-Surgery Costs

After surgery, you may need to pay for a compression garment, lymphatic massage, prescription medications, and other out-of-pocket costs.

Can Gynecomastia Surgery Be Covered by Insurance?

Can Gynecomastia Surgery Be Covered By InsuranceWe should start by clarifying that every health insurance company has a unique policy regarding coverage of plastic surgeries. Furthermore, all health insurance plans are also different.

It is not true that insurance never covers plastic surgery. But it is also not true that any surgery a patient or doctor deems medically necessary will be covered by health insurance.

Male breast reduction surgery is one of those “in between” surgeries, which can sometimes get insurance coverage, but which, unfortunately, rarely does. This usually comes down to the fact that gynecomastia patients are almost always seeking their surgery for cosmetic reasons — because they want to improve their appearance.

Some plastic surgeries may be covered by insurance — but only when they are not being performed for cosmetic reasons, but for reconstructive reasons. For example, if a woman requires a mastectomy because of breast cancer, she can get coverage for breast reconstruction (breast augmentation with implants) to recreate her original breast.

So, is gynecomastia surgery covered by insurance in any cases at all?

Rarely, the procedure may be covered. Usually, this occurs when a patient is younger than 18 years old. And still, insurance companies may only consider coverage, but it is not a guarantee.

Financing Options for Gynecomastia Surgery

Many patients go straight to Googling, “Is gynecomastia surgery covered by insurance?”, find out their procedure probably won’t qualify for insurance coverage, then abandon all hopes of ever getting the surgery.

This really isn’t the way to go about things if you’re serious about getting gynecomastia surgery. If insurance will not cover gynecomastia surgery costs for you, you still have other financing options. And if getting your gynecomastia fixed is something important to you, it’s worth figuring out a way to get it done.

Instead of giving up your hopes for surgery, we recommend you schedule a consultation appointment with a board certified plastic surgeon, or several plastic surgeons, who specialize in gynecomastia surgery. Meeting with a plastic surgeon directly to discuss your gynecomastia options will do several things.

First, your surgeon is going to be able to help you determine whether you actually need gynecomastia surgery. In some cases, patients can’t tell the difference between man chest fat vs gynecomastia.

Once your surgeon is able to perform a physical gynecomastia pinch test and examine your pectoral region directly, they can tell you whether gynecomastia surgery is the right corrective approach for you. Certain patients may only need to loose body fat or build up muscle in this area to correct their problem.

Next, your surgeon may be able to help you with financing. Many plastic surgeons offer financing options through CareCredit or other similar companies.

Questions and Answers

Is gynecomastia ever covered by insurance?

Although many insurers don’t cover it, some may cover part of gynecomastia surgery if deemed medically necessary. Severity of symptoms often determines coverage.

Can gynecomastia be medically necessary?

Surgical treatment for gynecomastia may be deemed medically necessary for Klinefelter’s syndrome patients with grade III or higher gynecomastia upon physical examination.

How can I fix gynecomastia without surgery?

Enhance diet and exercise routines. Explore off-label medications, hormone therapy, and alcohol reduction. Consider medication changes and address underlying health issues.

What is stage 3 gynecomastia?

Grade 3 gynecomastia is the most severe form, characterized by pronounced breast tissue growth in men. It presents as significant breast development akin to female breasts.

Does insurance cover gyno surgery?

Insurance cover gynecomastia surgery solely for emotional reasons. They also require that the condition be true gynecomastia, which involves the presence of actual breast tissue rather than fat. If chest enlargement is caused by fat, it is not considered true gynecomastia and can be treated with simple liposuction.

Can male breast enlargement be reversed?

If a disease is causing the condition, it must be treated to prevent recurrence after initial treatment. Addressing the underlying issues is crucial. Hormone therapy may be used to treat gynecomastia, and in rare cases, surgery might be necessary to remove the excess tissue.

Finding the Right Plastic Surgeon

Gynecomastia Surgery Covered By InsuranceIf indeed you do require gynecomastia surgery to correct excess glandular tissue in your pectoral region, it’s also worth meeting with a plastic surgeon because you want to know you’ve found the right professional to work with.

Unfortunately, some patients who are concerned with how to finance their gynecomastia surgery end up going to a plastic surgeon who charges an extremely discounted price, but who is not really qualified to perform this procedure. This may sadly result in botched gynecomastia surgery, which can be difficult to correct in some cases.

If you’re serious about correcting gynecomastia, make sure you see only a board certified plastic surgeon who has good reviews and experience performing male breast reduction surgery.

Contact Us Today to Schedule a Consultation

We understand that gynecomastia surgery can be costly, especially when insurance providers will not cover the procedure. If you are interested in this plastic surgery but have concerns about how to pay for it, please schedule a consultation to discuss financing options with us.


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