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Does Medicare Cover Breast Reconstruction After Mastectomy?
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?
Asked 32 months ago by
Violet Chic in Chicago
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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
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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.
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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.