Will Medicare Cover the Removal and Reconstruction of my Second Breast if It is Not Cancerous?

Doctor Answers (2)

Please seen by a Plastic Surgeon!

+1
If this is for an active cancer please be seen by a plastic surgeon. Please find an experienced Board Certified Plastic Surgeon and member of the Aesthetic Society using the Smart Beauty Guide. These Plastic Surgeons can guide you on all aspects of facial surgery, breast augmentation and body procedures including tummy tucks or mommy makeovers!


Austin Plastic Surgeon
5.0 out of 5 stars 12 reviews

Medicare/Insurance coverage of other non cancerous breast

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The short answer is yes and here is why:

The Federal Women's Health and Cancer Rights Act of 1998 is still the law today

Under the federal Women's Health and Cancer Rights Act of 1998, a yearly notification
of your benefits pertaining to breast reconstruction must be sent to you by your insurance company.
The Women's Health Care Act states that benefits must be provided for:
• Reconstruction of a surgically removed breast
• Surgery and reconstruction of the other breast to produce a symmetrical appearance
• Prostheses and treatment for physical complications from all stages of a mastectomy, including lymphedema

These benefits are subject to the conditions and terms of your plan, including maximum benefit amounts, deductibles

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 43 reviews

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.