Would Medicaid pay for breast implants if one boob is a cup size bigger then the other one?

My breast have gotten bigger from taking risperdal & now my right boob is at least a cup size bigger then the left one. This causes my bras not to fit properly. Would Medicaid pay to have this fixed?

Doctor Answers 7

Medicaid to pay for Breast Asymmetry

No Medicaid will not pay for that surgery as it is largely cosmetic. If you require reconstruction then you can get it pre approved through Medicaid.


La Jolla Plastic Surgeon
5.0 out of 5 stars 12 reviews

Asymmetry

Insurance will not pay for asymmetry unless the condition is due to cancer, congenital malformation or tramatic defect. Cosmetic surgery is not covered. Donald R. Nunn MD Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 11 reviews

Breast assymetry

In my experience, few insurance companies are willing to pay for one cup size of breast asymmetry. Best of luck.

Would Medicaid pay for breast implants if one boob is a cup size bigger then the other one?

That would be extremely unlikely. If it did pay, the reimbursement would likely not be enough to cover the costs of the plastic surgeon performing the surgery.

Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

Medicaid covering side effects of medications

may be covered but I would speculate they would prefer to cover a reduction of the side the grew rather then provide you with implants. You would need to find a provider and pursue through their office if they feel you have medical reasons that would allow for this.

Curtis Wong, MD
Redding Plastic Surgeon
5.0 out of 5 stars 20 reviews

Breast Asymmetry Covered by Medicaid

Unfortunately there probably isn't any insurance company that will cover your asymmetry as it is not considered medically necessary. Breast reduction surgeries are sometimes covered when they cause physical pain, even then it can be hard to get approval. Find a Board Certified Plastic Surgeon that specializes in breast surgery to help you find options such as financing. Good luck!

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 47 reviews

Medicaid Coverage of Breast Asymmetry Surgery?

I do not have any experience with Medicaid paying for the type of surgery you are describing. Ultimately, you will need to be careful with the selection of your plastic surgeon.

You may be best off gradually saving for the procedure and having it performed by the plastic surgeon who can demonstrate the most experience achieving the types of results you are looking for, as opposed to a plastic surgeon who will perform the procedure covered by a specific "insurance".

Best wishes.

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.