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Insurance Coverage for Lift and Implants for Deformed Breasts?

After having 3 children and losing the weight before even leaving the hospital, my breasts are very deformed and I am unable to find a bra or bathing suit to even fit properly. I weighed about 160 pounds per child then returning to 100-110 pounds. There is just no way to keep them in a bra. Is it possible to get breast implants and breast lift through insurance coverage for this?

Doctor Answers 15

Probably not

Unfortunately, insurance won't cover your surgery unless you have medical issues directly caused by your saggy breasts. But just to make sure, you can always ask your provider.

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Usually insurance doesn't cover breast lifts

Insurance doesn't usually cover the cost of a breast lift, however you should contact your insurance provider to find out if yours is covered. If it is, it would have to be deemed medically necessary.

Insurance Usually Does Not Cover Breast Lift With Implants

         Unfortunately, breast augmentation and mastopexy are both considered to be cosmetic procedures by insurance companies. Under these circumstances, coverage would be denied and payment would be the patient’s responsibility. 

Insurance coverage

I agree with the other doctors.  In my area, insurance does not cover the cost of the surgery that you need. 

Shim Ching, MD
Honolulu Plastic Surgeon
4.5 out of 5 stars 18 reviews

Cost and insurance for breast lift

Cost is geography dependent. In Florida it runs $8000-10000. More important than price is safety and experience. Also, as an aside, breast lift, has never been a covered procedure with any insurance carrier unless it is to match a breast reconstruction for breast cancer.

Implants and insurance coverage

 

In my experience, insurance covers  only procedures that are medically necessary.  Breast implants and lifts are usually elective procedures and not covered by insurance.

 

Breast Augmentation/Mastopexy and Insurance?

The breast augmentation/mastopexy procedure is considered a medically unnecessary/cosmetic procedure regardless of the causes of the breast hypoplasia/ptosis. Therefore, the procedure will not be covered by health insurances.

Best wishes.

Will insurance cover deformed breasts?

I wish that insurance would cover your situation. As you may know, breast reconstruction following cancer surgery is a covered procedure because breast cancer patients lobbied tirelessly to make this a mandated service. However, without such a mandate, your insurance company is likely to deny the surgery as cosmetic until you have a related condition, such as intractable rashes under the breasts which are unresponsive to dermatological management. I would expect insurance to deny the case but, nevertheless, would recommend that you ask your plastic surgeon to apply for pre certification. You never know and all it takes is one medical director who might find the photos compelling, particularly if you aren't dealing with a national company with rigid standards.

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 16 reviews

Breast Surgery Needed

Unfortunately breast augmentation is a cosmetic operation and will not be covered by your insurance carrier.

Richard Linderman, MD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 9 reviews

Breast Augmentation and Mastopexy / Insurance Coverage for Breast Surgery

It sounds like breast augmentation and mastopexy is just what you need to solve your problem. Although your breast deformity resulted from pregnancies and possibly breast feeding, these procedures are not covered by health insurance policies because there is no medical indication for them. Although it is inconvenient and uncomfortable to have difficulty fitting properly into a bra or bathing suit, it is not considered to be a medical problem or health risk but rather a cosmetic deformity.  The only medical indications for which breast augmentation and breast lift procedures are covered by insurance policies are for improving symmetry in patients with breast cancer and in some cases for correction of congenital deformities of the breast.

Max Polo, MD
Miami Plastic Surgeon
5.0 out of 5 stars 26 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.