Is Hypoplastic Breast Reconstruction Covered Under Insurance?

asked 9 months ago by Tracersfromtexas in Ft worth Texas
Latest answer by Jerry Lugger, MD
Question viewed 333 times
Tags: coverage, insurance

6 answers to Is Hypoplastic Breast Reconstruction Covered Under Insurance?

Insurance coverage for breast hypoplasia

Unfortunately most insurance carriers consider this a cosmetic procedure now; I occasionally got this covered a number of years ago, but it is routinely denied now. If the correction involves a component of soft tissue reconstruction (e.g. a flap reconstruction) it might be that a pre-determination would be worthwhile, but certainly no guarantees could be made that this would afford insurance coverage.

Jerry Lugger, MD
Dallas Plastic Surgeon

It may be covered by the insurance if need more than implant for augmentation

If you have true breast deformity ,your insurance may cover it if requires reconstruction rather than augmentation . Depending on your insurance company and their restrictions, reconstruction may be covered. The most common diagnosis that covered is Poland's syndrome which is complete absence of the breast tissue.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Hypoplastic breast insurance coverage

Occasionally a onesided hypoplastic breast may be covered by generous insurance carrier. Visit with a local plastic surgeon for an evaluation and if deemed appropriate a predetermination letter can assess the possibility of your carriers coverage. Good luck