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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 (13)

Insurance Usually Does Not Cover Breast Lift With Implants

+1

         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. 


Omaha Plastic Surgeon
5.0 out of 5 stars 78 reviews

Insurance coverage

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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
5.0 out of 5 stars 14 reviews

Cost and insurance for breast lift

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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.

Raj S. Ambay, MD
Tampa Plastic Surgeon
4.0 out of 5 stars 15 reviews

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Implants and insurance coverage

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

 

George John Alexander, MD, FACS
Las Vegas Plastic Surgeon
5.0 out of 5 stars 23 reviews

Breast Augmentation/Mastopexy and Insurance?

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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, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 751 reviews

Will insurance cover deformed breasts?

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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 12 reviews

Breast Surgery Needed

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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 7 reviews

Breast Augmentation and Mastopexy / Insurance Coverage for Breast Surgery

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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 13 reviews

Breast lift and implants ande insurance

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Sorry, but what you want is considered a cosmetic surgical procedure that is not covered by insurance.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Insurance coverage limited to Breast Reconstruction after Mastectomy

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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.

C. Bob Basu, MD, FACS
Houston Plastic Surgeon
4.5 out of 5 stars 123 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.