I had a partial masectomy from a large lump that was in my breast. I did not need any further treatment afterward. It was diagnosed as an infected cyst instead of a suspected phyllodes tumor that runs in my family. I have state insurance which covered the masectomy but do I have good chance to get coverage for the reconstruction? I was already approved for a consultation, but not sure if I can get my hopes up. My right breast has is less than 1/4 the size of the left and I have no feeling
Chance of State Insurance Covering Reconstruction After Masectomy?
Doctor Answers (4)
Insurance Covers Post Mastectomy Reconstruction
Your description would certainly fall under the category of breast reconstruction. Therefore I think you have a high likelihood that your State Insurance would cover your partial mastectomy reconstruction.
Mastectomy Reconstruction Should be Covered
Based on a 1998 Federal law that mandates post-mastectomy breast reconstruction insurance coverage, your reconstruction should be covered by your insurance. Best of luck.
Lumpectomy defect treatment coverage depends on your policy
You'll need to review your carrier's policy manual on this. The federal legislation that mandates coverage of breast reconstruction, the WHCRA Act, does not include partial mastectomy in it's language. Different insurers have different positions on whether you would be considered covered for this.
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