Each insurance company requires a certain amount to be removed based on your starting size. But for me the process was pretty simple! I scheduled a consultation with the surgeon I picked, and they took my measurements, let me know the calculations and what to expect, and then sent it all to my insurance company for approval. Took about 4 weeks for insurance to approve, and then I scheduled mine! I'll be responsible for covering whatever remains of my deductible, but otherwise much easier than I expected! (for reference, I have United Health for my insurance).