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Will Insurance Pay for Complications Resulting from Breast Implants?

If something like a infection develops after getting breast implants, will the treatment of the infection be covered by insurance?

Doctor Answers (8)

Insurance Coverage and Breast implant complications

+1

By law, insurance companies must pay for implants used in breast reconstruction associated with cancer.  Everything else will be considered cosmetic and not be covered including complication.. Every insurance is different with the exception that they profit by not paying for health care services. There is a perverse incentive to collect premiums from consumers and not pay for care. You have to be your strongest advocate for your health. As a consumer, call your insurance company and make your case. I bet your doctor will assist you with all the medical documentation.

Tampa Plastic Surgeon
4.5 out of 5 stars 12 reviews

Insurance and breast augmentation

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In general, most insurance companies will not cover complications related to cosmetic surgery, but they may. you should contact your insurance company.

Manhattan Plastic Surgeon
4.5 out of 5 stars 14 reviews

Complications from implants and insurance

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Insurance will generally not cover complications arising from cosmetic surgery, but you should check with your individual plan. There is a form of cosmetic surgery insurance called CosmetAssure, which is available in some states. This is usually very affordable and very worth it for peace of mind prior to elective surgery. Good luck, /nsn.

New York Plastic Surgeon
4.0 out of 5 stars 5 reviews

Insurance Coverage for Breast Implant Complication

+1

Unfortunately, insurance companies will usually not cover complications from cosmetic surgery. The only time insurance companies will cover implants and implant related complication is if you have undergone implant reconstruction for breast cancer. CosmetAssure is a qualified insurance program that helps cover some complications after cosmetic surgery.

Houston Plastic Surgeon
4.5 out of 5 stars 101 reviews

Insurance coverage for complications of breast implants

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Unfortunately, insurance companies are increasingly denying coverage of medical conditions if they attribute them to the breast implants. Interestingly they will pay for complications of alcohol and tobacco abuse but not  always for breast implants.

Web reference: http://www.bodysculptor.com/breast.html

Chicago Plastic Surgeon
5.0 out of 5 stars 39 reviews

Insurance coverage for complications from breast implants

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The VAST majority of medical insurance companies do not cover / pay for ANY complications resulting from any cosmetic surgical procedure.

Their philosophy is that since they did not pay for the original procedure - why should they be financially responsible for any complications arising from it?

That is why any reader of these pages hears the SAME comment again and again - go to a real Plastic surgeon, one who is a member of The American Society of Plastic Surgeons (www.PlasticSurgery.org).

When you get the cheapest guy in town, your surgery will be done most likely by someone who is NOT board certified by The American Board of Plastic Surgery and as such the likelihood of complications (resulting in much greater expenses to you) will be high.

Memphis Plastic Surgeon
5.0 out of 5 stars 52 reviews

Insurance Coverage of Complications

+1

Most, but not all, insurance cos. have an exclusion for complications resulting from cosmetic surgery.  You can check your policy to see if this exclusion is in your policy.  If so, then CosmetAssure is an option that you can consider.

Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Insurance coverage for cosmetic complication

+1

Hi,

Assuming the breast implants were placed for cosmetic purposes (i.e. breast augmentation and not breast reconstruction for cancer), insurance companies will not cover complications arising from the procedure.

For that reason, many of us participate in a program called CosmetAssure. It's an insurance program for possible complications arising from cosmetic surgery - only patients of board-certified plastic surgeons are eligible to participate. If a complication were to arise, the medical costs arising from the treatment are covered. It's a relatively small fee for each patient, but it goes a long way in ensuring peace of mind.

Hope this helps. Best of luck.

Dallas Plastic Surgeon
5.0 out of 5 stars 23 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.