Trying to get Medicare to pay for gene testing. My grandmother and mother both had breast cancer, and I'm an Ashkenazi Jew. If I pay for the out of my own pocket, would Medicare cover a bilateral mastectomy and reconstruction?
Medicare and Prophalactic Breast Surgery?
Doctor Answers (3)
Medicare and Prophylactic Breast Surgery?
In my previous experience with Medicare, they would not preapprove your procedure but would do so after the fact when all the documentation is in. Although sometimes they do not approve it and you would be responsible for the billing. In your case it should be covered.
Yes I believe that prophylactic mastectomies and certainly a breast reconstruction is covered by medicare
Gene Testing and Prophylactic Mastectomies and Reconstruction
If you test positive for certain markers, the prophylactic mastectomies as well as the reconstruction with implants may be covered by Medicare. Kenneth Hughes, MD Los Angeles, CA