Why Don't Insurance Companies Cover Breast Implants?

asked 2 years ago by babydoll in dhs california
Latest answer by Steven Wallach, MD
Question viewed 1,059 times
Tags: insurance

11 answers to Why Don't Insurance Companies Cover Breast Implants?

Breast implants and insurance

The basic philosophy of medical insurance is to cover treatments that are "medically necessary" for your health and survival. Premiums are collected from patients to cover these costs. So, if your insurance paid for your implants, technically it would be the other patients who were buying your implants and that would not be appropriate and would seriously raise everybody's premiums.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Insurance and breast implants

Insurance will cover for breast implants if these are part of a reconstruction for breast cancer. Other than that you are on your own.

Steven Wallach, MD
Manhattan Plastic Surgeon

Insurance coverage for breast implants

Hi, Thank you for your question! Insurance companies will cover breast implants if they are medically necessary. They are only medically necessary after a mastectomy/breast cancer in terms of breast reconstruction. Insurance companies will not cover any procedures that are for cosmetic purposes and not necessary. This unfortunately includes breast implants. Best regards, Dr. Speron

Sam Speron, MD
Chicago Plastic Surgeon

Insurance coverage of breast implants

Insurance will cover breast implants if they are being placed for reconstruction, as for example after mastectomy for breast cancer. They will not cover any cosmetic surgery, including breast augmentation, breast lift, tummy tuck, etc.

Nina S. Naidu, MD
New York Plastic Surgeon

No insurance coverage for elective cosmetic surgery

I feel your question is why does insurance not cover cosmetic operations including breast implants. Simply there is no coverage or benefits for non necessary surgery. If you do not have a functional deformity than NO insurance company will cover COSMETIC SURGERY. Hope this answers your direct question.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Insurance companies coverage of breast implants

Hi Babydoll - Insurance companies only cover breast implants when they are used for breast reconstruction after trauma or after a mastectomy for breast cancer. If the implants are to be placed for cosmetic reasons, then insurance companies won't cover the costs.

Jeffrey E. Schreiber, MD
Baltimore Plastic Surgeon

www.BaltimorePlasticSurgery.com

Cosmetic procedures not covered by insurance

Insurance companies deem certain procedures as not being medically necessary. Breast implants, breast augmentation and breast lift are included in this category. Even physical conditions which can have tremendous psychological implications are excluded from insurance coverage such as breast augmentation for congenital abnormalities.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon

Sometimes insurance companies DO cover breast implants: depends on the indication

Generally speaking, insurance companies will pay for medically necessary or functional surgery but will deny coverage of cosmetic procedures. When breast implants are used for breast reconstruction, they will typically pay. When implants are used for cosmetic purposes, it will most commonly be denied. There is confusion about congenital breast deformities but as time passes, these companies seem to deny more and more procedures.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Medical insurance companies are keeping costs down

Hello, Basic to medical insurance is the attempt to collect as much as they can and cover as little as they can. Long ago the concept of denying procedures as cosmetic became accepted. In plastic surgery, most things follow from there.

John P. Di Saia, MD
Orange Plastic Surgeon

Insurance won't cover breast implants because they're cosmetic

The reason that health insurnace does not cover implants is that they consider it cosmetic. That is, there is no medical or functional problem. The problem is that the patient wants larger breasts. If they did cover that type of procedure they would have to charge quite a bit more. Several years ago some insurance companies put in their policies that they would cover breast augmentation as a marketing tool to get more people to sign up. The problem was that no plastic surgeons signed up... more

John P. Stratis, MD
Harrisburg Plastic Surgeon

Medical Insurance paying for Breast Augmentation

Are you paying for your own health care insurance OR is is largely bought and subsidized by your employer? If you had personally purchased your own policy you would quickly realize that it is essentially an Ala Carte Menu where each item covered adds to the total cost of the policy. (You want to be able to go to more than one hospital? Sure - but it will cost you. Want physical rehab services? Absolutely, but it will cost you. Want Mental Health services, Dental Services, Prescription... more