I am a 34-year-old black woman who has struggled with the physical and emotional burden of large breasts my entire adult life. I lost over 75lbs in an effort to lead a healthier lifestyle, but as a result, the weight of my breasts has now become extremely unbearable. I am 5'7 175lbs and wear a 36i bra cup and have found myself disqualified from breast reduction surgery due to Aetna's unstudied and unproven medical necessity requirements of the Mosteller Formula. My surgeon is refusing to remove 885g (1.95lb) tissue per breast Aetna is requiring due to the higher risk of complications and unproportionately small breasts, leaving me hopeless and stuck in physical and psychological pain. Aetna is the only major insurance policy that implements this formula. Most other insurance policies and most studies are based on a 500g minimum which most literature already concludes is unfair. 

The Mosteller formula is a 36-year-old formula that has never been studied in regard to breast tissue removal weights however Aetna uses it to deny medical necessity in women suffering. The Mosteller formula was intended to initially calculate dosages for cancer treatment in children and has barely been studied since. Aetna's breast reduction policy disqualifies most women seeking relief from the physical and emotional strain caused by overly large breasts because of this formula. This policy is not only unfair and biased but also lacks substantial evidence to support its implementation. The Mosteller formula's use even without evidence of validity and has forced many women who are suffering to pay for the surgery, which I was quoted $21,000, as cosmetic even though scientific literature supports medical necessity. Aetna's negligence in implementing the Mosteller formula without scientific evidence has caused me and I'm sure many other women extreme emotional distress further worsening the psychological impact of this condition and its consequences.

According to The American Society of Plastic Surgeons, breast reduction surgery can alleviate discomfort associated with overly large breasts such as back pain, neck pain, and skin irritation (ASPS). Yet, despite these proven benefits, Aetna continues to impose unproven restrictions that deny many women access to this life-changing procedure. The fact that the formula lacks scientific evidence is against the law, but no one has done anything about it for years. Doctors have been convincing women to pay for is as cosmetic because they don't want to question the formula or policy. With such a high cost I will be forced to live in pain for the unforeseeable future as many other women suffering from this condition have. I filed 2 appeals asking Aetna to consider the emotional and psychological, and sexual assault consequences of this condition. 

Not a single one of my concerns, disputes or my requests for proof of the validity of the formula was acknowledged. Aetna has already had a medical director go on record in the past admitting he didn't read claims before denying them, and it resulted in an unnecessary death. Aetna is continuing their practices as evident in my appeal decisions by not considering anything I wrote, and it needs to end now. Imagine how many women were forced to go into debt to get this procedure done as cosmetic when they should have qualified for the procedure under medical necessity based on scientific evidence. Imagine how many women are forced to live with the physical and psychological pain because they can't afford the surgery due to Aetna's illegal practices. 

We are calling on Aetna to reform their unjust policy on breast reductions. Their next clinical review for the policy is 1/11/24 and it is time for them to recognize the validity of our struggles and provide us with the necessary healthcare based on scientific evidence that we deserve. Please sign this petition if you stand for fair health policies that prioritize patient wellbeing over arbitrary biased guidelines that solely benefit Aetna.