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Does Medicare Cover Breast Reconstruction After Mastectomy?

asked 2 years ago by Violet Chic in Chicago
Latest answer by Steven Wallach, MD
Question viewed 5,202 times
Tags: insurance, medicare

Does Medicare cover Breast reconstructive surgery  after bilateral prophylactic Mastectomy for patients with BRCA positive gene mutation and strong family hx (medical history) of breast cancer?

5 answers to Does Medicare Cover Breast Reconstruction After Mastectomy?

+1

Breast reconstruction and Medicare

All insurance companies will cover breast reconstruction after mastectomy.  Medicaid will covet this for you.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Breast reconstruction is covered by Medicare

Yes.  Breast reconstruction and equalizing surgery on the other breast is covered. You should not have any trouble get the procedures done providing that you find a plastic surgeon that accepts your Medicare benefits. Best wishes.
Earl Stephenson Jr., MD, DDS

Atlanta Plastic Surgeon
+1

Medicare covers breast reconstruction

Dear Violet Medicare does cover breast reconstruction as well as the procedure on the opposite side to make the breasts even. Many plastic surgeons are willing to accept at least a portion of the costs from medicare and the secondary. There may be some additional fees but you should discuss this with your plastic surgeon in advance. Good luck. Steven Schuster MD FACS
Steven Schuster, MD

Boca Raton Plastic Surgeon
+1

Yes, Medicare will cover Breast Reconstruction

Insurance will cover breast reconstruction following mastectomy. Furthermore, Medicare should also cover any procedure performed on the opposite breast for symmetry purposes. For example, in order to match the reconstructed breast, the opposite breast may require a breast lift or reduction. Medicare and private insurance should cover this as well.
Jason C. Ganz, MD

New York Plastic Surgeon
+1

Medicare covers breast cancer reconstruction

Yes Medicare will cover breast reconstruction following breast cancer reconstruction. However, the fees that they are willing to pay are generally lower than many plastic surgeons are willing to accept. Therefore, many plastic surgeons do not participate nor do they accept assignment for such cases. In these instances, you may likely have to pay out of pocket expenses.
Otto Joseph Placik, MD

Chicago Plastic Surgeon

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