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Is a Breast Revision for Reconstruction After a Matectomy Normally Covered by Insurance?

asked 8 months ago by NotwhatIthought in O Fallon, IL
Latest answer by Vivek Bansal, MD
Question viewed 75 times
Tags: insurance, mastectomy

I was wondering if a revision surgery for breast reconstruction after a mastectomy is normally covered by insurance? Are there certain things that would make coverage more or less likely? I am no longer with the same carrier who covered the mastectomy and reconstruction, however I do have coverage for preexisting conditions. Thank you for any help you can provide here.

2 answers to Is a Breast Revision for Reconstruction After a Matectomy Normally Covered by Insurance?

+2

In New York State, coverage of breast reconstruction for breast cancer is mandated, and

Coverage includes necessary revisions of the reconstruction, and surgery on the opposite (non-cancerous) breast for symmetry. Following mastectomy, reconstruction with either an implant or your own tissues are covered by both government and private carriers. If a revision is necessary, your surgeon should send the necessary documentation to your insurance carrier and obtain pre-certification of coverage of the revision.
Michael H. Rosenberg, MD

White Plains Plastic Surgeon
+1

Breast Reconstruction

Insurance carriers are so variable on what they cover, how much they cover, and how long they will cover a given problem that you need to call your carrier and get information in writing on what is covered, and then you can make firm plans on what you want to do next.
Vivek Bansal, MD

Danville Plastic Surgeon

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