Will Insurance Pay for Inverted Nipples with Sagging Breast?
Doctor Answers (11)
Correctiono of inverted nipple
The correction of inverted nipples is not usually a covered procedure. You can call your insurance company and ask to speak with a claims representative and make the inquiry yourself. The surgery for an inverted nipple is usually very simple and can be performed under local anesthesia as an outpatient.
Inverted Nipples/Mastopexy and Insurance Coverage?
Thank you for the question.
Correction of inverted nipples and/or breast lifting surgery are not procedures generally covered by health insurance plans.
Some information regarding inverted nipple surgery may be helpful...
Inverted nipples can cause functional problems for women and emotional concerns. An inverted nipple can look flat or a slit like depression or hole at the normal nipple location. There are different degrees of inverted nipples possible. Whether a patient is a candidate for correction of inverted nipples depends on the extent of the problem.
Usually correction of the inverted nipples involve division of the lactiferous (milk ducts). The risks of the procedure include potential loss of sensation, inability to breast-feed, recurrence of the asymmetry and the potential need for further surgery.
My advice to patients go something like this... If the nipple is permanently inverted and does not evert with stimulation, then it is a useless nipple when it comes to sensitivity and/or breast-feeding. In these cases correction of inversion is indicated (because the potential gains outweigh the risks outlined above). On the other hand, if the nipple does evert spontaneously with or without stimulation, then I am more reluctant to perform the procedure given that the risks may outweigh the potential benefits. At that point, the decision is the patient's to make after careful consideration.
I hope this helps
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Insurance rarely pays for cosmetic surgery
It is very rare for any health insurance to pay for cosmetic surgery. Inverted nipples that occur with ptosis (sagging breast) may be nicely corrected with a breast lift or Mastopexy. For patients undergoing breast reconstruction, insurance companies will pay for a Mastopexy on the opposite side to correct for asymmetry. Other than this situation, it is unlikely that they would pay for the procedure you are inquiring about. Good luck.
Insurance and inverted nipples and sagging breasts
It is hard enough to get a formal breast reduction covered by insurance. I would be extremley surprised if an insurance company would cover basically a breast lift and inverted nipple repair.
VIDEO: Mastopexy (breast lift) and inverted nipple repair: Insurance coverage
In my experience, insurance companies do not pay for breast lift procedures nor do they cover inverted nipple repair unless you have a liberally interpreted medical savings account plan.