Insurance Coverage Change After Implants?

After getting breast implants, can insurance companies drop you? Or raise your premium? I've also heard some companies won't cover the cost of treating breast disease if you have breast implants- is this true? Do you know which insurance companies do this? Thanks!

Doctor Answers (12)

Insurance coverage after Implants

+2

I have never heard of anyone losing their health insurance coverage, or having their premiums raised, following a breast augmentation. I have also never heard of someone having treatment of breast disease be denied cosverage because they have breast implants, and I believe that state law would prohibit this. I have performed breast reconstruction on a number of patients who have implants and there has never been a problem. You would need to check your specific plan policy provisions for any possible exclusions.

It is true that today most insurance plans exclude covering any complications related to cosmetic surgery. For example, if you should have bleeding after a breast augmentation that required an emergency operation at the hospital at 2 AM, there is a good chance your insurance would not pay for the hospital charge. In the past, some insurance companies would pay for removal of old leaking gel implants, but I find that most will not cover this any longer, despite the fact that the gel can create problems if it gets into the surrounding breast tissues.


Federal Way Plastic Surgeon
5.0 out of 5 stars 22 reviews

Breast augmentation should not affect your health insurance

+1

Hello,

Breast augmentation should not affect any part of your health insurance of your breast health coverage.  If you go to your insurance company website there is usually a section on elective surgery.  You could always call them to solidify this in your mind but I have never heard of any insurance issues after breast augmentation.

All the best,

Dr Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 91 reviews

Insurance after breast augmentation

+1
As far as I know most of the major carriers will not drop a person with breast implants. It is also unheard of for a carrier not to cover other forms of breast disease in patients with implants. In fact, some companies do cover the removal of ruptured silicone implants. To be safe ask your insurance carrier.

Robert M. Jensen, MD
Medford Plastic Surgeon
4.5 out of 5 stars 20 reviews

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Usually not but checkwith your insurer

+1

The insurance coverage subject is very complicated and involves many rules and regulations. Every individual’s insurance has different plan and different benefits for the patient under the plan. To check for any changes regarding the implants insertion you have to call your insurance company and speak to representative directly. You should be able to find out what is involved and how your plan will be  different from the one you have now.

Gregory Turowski, MD, PhD
Chicago Plastic Surgeon
4.5 out of 5 stars 25 reviews

Insurance Coverage Change After Implants?

+1

I have NEVER heard of this issue before. But anything today does not surprise me. Check with your health insurance company if there are restrictions in having cosmetic surgery and get the response in writing. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 62 reviews

Insurance Coverage Change After Implants?Answer:

+1

Many companies have a rider that states that they will not cover any complication related to your breast implants or any cosmetic procedure for that matter.  As far as denying or dropping coverage because you have implants. I have not heard of that, but then again, I would never be surprised by anything that an insurance company does! Check your policy. Some old policies covered women for a ruptured gel implant removal. They paid for the removal of the implant but not reinsertion of a new one!

John J. Corey, MD
Phoenix Plastic Surgeon
4.5 out of 5 stars 16 reviews

Breast implants and insurance coverage

+1

This is going to vary widely with the type of insurance plan that you have and the laws in your state.  Check with your insurance company and review your policy prior to signing up for insurance.

I don't know of any such policies by any insurance companies.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 33 reviews

Breast Implants and Insurance Coverage

+1

Dear SeattleNatalie,  Under current laws, insurance carriers must cover the treatment for breast diseases such as breast cancer whether you have implants or do not have implants.  As far as can they change your policy  or charge you more after having implants placed for cosmetic reasons, though I have not heard of this being done in my area of the country, every insurance company can pretty much do what they want as long as they stay compliant with state and federal laws.  This is why there is such a variety of coverages from company to company.  If you are currently insured by a carrier, read your policy carefully to see what exclusions they may have placed in your policy regarding breast implants.  If your insurance is through your work, you may also wished to discuss this with your HR Director who should be able to help you sort out the answers.  Most insurance carriers however do not cover the costs of treating complications from implants placed for cosmetic reasons.  Sorry that I cannot be more specific but good luck.

Herluf G. Lund, Jr, MD
Saint Louis Plastic Surgeon
4.0 out of 5 stars 18 reviews

Breast Implants and Insurance Company Issues?

+1

Thank you for the question.

Unfortunately,  it is not possible to generalize the answers to your questions. It would be in your best interest to communicate directly with the health insurance companies you are involved with or are considering. You will find it each company likely has different policies regarding issues surrounding breast implants.

 

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 715 reviews

Insurance and breast surgery

+1

here are some issues related to insurance and breast surgery:

  • all companies have different coverage
  • some states have regulations regarding what is not covered
  • some companies have disclaimers on problems related to implants
  • its rare for any company to cover complications of implants

check your policy carefully

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 16 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.