Q.: Is breast reduction covered by OHIP?
Dr. Brown answers: “A breast reduction procedure may be performed for functional reasons (back pain, neck pain, shoulder grooving, rashes under the breast) or for non functional/aesthetic reasons including personal desire for smaller or lifted breasts, discomfort with exercise, problems with fitting clothes or an upper body that is out of proportion with the rest of the body.
OHIP will consider coverage on a case by case basis when the indications for surgery are primarily functional. An approval form must be submitted by the surgeon directly to OHIP. If approved, the goal of the breast reduction will be to remove enough breast tissue to effectively treat the symptoms and the functional concerns of the patient.”