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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?

Asked 28 months ago by itsme79 in united states
Sort 9 expert answers by:
+2

Breast lift and implants ande insurance

Sorry, but what you want is considered a cosmetic surgical procedure that is not covered by insurance.
Steven Wallach, MD
Manhattan Plastic Surgeon
+1

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.
Tom J. Pousti, MD
San Diego Plastic Surgeon
+1

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... more
Robert L. Kraft, MD
New York Plastic Surgeon
+1

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
+1

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... more
Max Polo, MD
Miami Plastic Surgeon
+1

Insurance coverage limited to Breast Reconstruction after Mastectomy

Dear Itsme79: It is very unlikely any insurance company will cover your surgery. It will be deemed cosmetic. The only breast surgery that must be covered is breast reconstruction after mastectomy as per the only health care mandate that exists in federal law (1998 law). My recommendation would be to visit with an American Society of Plastic Surgeons member surgeon. Their office will likely shared with you options for your surgery including financing plans such as Care Credit.... more
C. Bob Basu, MD
Houston Plastic Surgeon
+1

Insurance will not pay for breast lift and augmentation

Sorry. I am not aware of ANY medical insurance policy that will pay for this procedure or any other cosmetic procedures. In fact, we are having an increasingly hard time getting insurance companies to pay for many other Reconstructive Plastic surgical procedures since they like to lump ALL plastic surgery procedures into the cosmetic pile.
Peter A. Aldea, MD
Memphis Plastic Surgeon
+1

Insurance coverage for cosmetic breast surgery

The insurance companies have gotten far away from treating anything that is not what they consider to be "functional." In other words, if you can live, eat, breathe, and work with it, then it is not a funtional problem and not necessary to cover it. Therefore, what you have, while it is very displeasing for you, would be considered entirely cosmetic. You certainly can have a nice restoration but it wouldn't be covered by insurance.
Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
+1

Insurance for Implants

Dear Itsme79 Unless you have a Mercedes Benz type of plan I know of no insurance that will pay for breast lift with implants as a result of having children. If you have a Health Savings Account some of them allow the money to be used for cosmetic surgery. The only time I know of insurance covering the cost of implants is for breast reconstruction after mastectomy and a symmetry procedure for the opposite side. If finances are a major concern you might want to try calling the medical... more
Steven Schuster, MD
Boca Raton Plastic Surgeon
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