Additional medical procedures available

Medically-necessary breast reduction surgery

Candidates for Breast Reduction Surgery must meet ALL of the following criteria for Macromastia:

  1. Member has persistent symptoms in at least 2 of the anatomical body areas below, affecting daily activities for at least 1 year:
    1. Headaches
    2. Pain in neck
    3. Pain in shoulders
    4. Pain in upper back
    5. Painful kyphosis documented by X-rays
    6. Pain/discomfort/ulceration from bra straps cutting into shoulders
    7. All of the following criteria are met:
      • Member has undergone an evaluation by a physician who has determined that all of the following criteria are met:
      • Photographic documentation confirms severe breast hypertrophy; and
        • There is a reasonable likelihood that the member's symptoms are primarily due to macromastia; and
        • Reduction mammoplasty is likely to result in  improvement of the chronic pain; and
        • Pain symptoms persist as documented by the physician despite at least a 3-month trial of therapeutic measures such as:
          • Analgesic/non-steroidal anti-inflammatory drugs (NSAIDs) interventions
          • Physical therapy/exercises/posturing maneuvers
          • Supportive devices (e.g., proper bra support, wide bra straps);
  2. Women 40 years of age or older are required to have a mammogram that was negative for cancer performed within the year prior to the date of the planned reduction mammoplasty

Please contact HR Benefits at 504-658-8615 with questions.

Medically-necessary lap band/lap sleeve surgery

Lap Band/Sleeve Surgery will be limited to members with the following criteria:

  1. Your BMI is more than 40; or more than 30 with obesity related health conditions
  2. You are between the ages of 18 and 60
  3. You have been overweight for 5 years or more
  4. You do not have an illness that has caused you to be overweight
  5. You are committed to making changes in your diet and lifestyle
  6. You are willing to continue working with and be monitored by your LAP-BAND doctor
  7. Hypertension
  8. Cardiopulmonary condition
  9. Sleep apnea
  10. Diabetes

The City contribution to the cost of Lap Band/Lap Sleeve surgery will be limited to a maximum of $15,000.

Please contact HR Benefits at 504-658-8615 with questions.