Insurance for Breast Reconstruction

Health Insurance

Breast reconstruction procedures should be covered by your health insurance plan. This includes procedures that may be needed over time to refine the results.

The Women’s Health and Cancer Rights Act of 1998 requires all group health plans that pay for mastectomy and to also cover prostheses and reconstructive procedures. In addition, Medicare covers breast reconstruction, while Medicaid coverage can vary from state to state. Government- and church-sponsored plans are not necessarily required to cover reconstruction, so you may need to check with your plan administrator.

It is always important to communicate with your health insurance provider right away and check on what is covered so you can avoid the work of trying to get payment later.

Remember that you’ll still be responsible for your deductible and co-pays, so make sure you understand how much you’ll be paying out of pocket. Costs can vary widely, but implant procedures generally do cost less than tissue flaps. However, they’re more likely to require adjustment in the future, so the overall cost may even out.

If you have any questions regarding insurance for breast reconstruction, contact our office or your financial provider today.