Why Insurance Companies Screw Us Over: The Schnur Scale Revisited

I get frequent emails and messages from women who are themselves trying or who are assisting a loved one get their reductive mammoplasty covered by insurance. These messages are heavy and heartbreaking. They describe women in a great deal of emotional and physical pain. Some have lesions from their bra straps. Some haven’t taken a sweatshirt off in years. Others are so depressed they consider suicide. All of them want answers on how to get their reductions covered by insurance. 

The only way I can answer these emails is with support and some advice. I don’t have answers for them because the system is rigged.

That is because of the widespread use by insurance companies of the Schnur Sliding Scale. This scale, as antiquated and one-dimensional as the BMI scale, is what insurance companies use to deem a reductive mammoplasty “medically necessary”. I have repeatedly spoken against this standard as problematic and highly restrictive as it only factors in weight and height. It doesn’t consider body composition, musculature, or body structure. It doesn’t care if your breasts have resulted in scoliosis or depression. 

For a long time I was angry at this Dr. Schnur who had set this arbitrary and misguided standard. Then I did some digging and found an article written by the Dr. himself. In this article, Dr. Schnur writes that insurance companies have “misused” his data. He says “In the original article we did not recommend how this information should be used.” He goes on to suggest more medically appropriate ways in which third part insurers should allocate “medically necessary” procedures.

I couldn’t believe what I was reading. A man who I had thought helped perpetuate these overly-restrictive and destructive standards had come out to speak against them. I thought he was honorable. 

Since that discovery I have worked to figure out who I needed to speak to to help bring awareness to this
very convenient oversight by insurance companies. I’ve found that this requires assistance from organizations and from individuals who have a strong voice. I have reached out to congresswomen to help create a platform to bring light to this misguided policy. 

If you would like to help, please reach out to me. 



Meghan Fitzpatrick