Last year, while breast feeding my first child, I developed a severe case of mastitis which then turned into a MRSA infection and had to have tubes placed in my right breast to drain the infection. Then, I developed a milk fistula which took months to heal. As a result, my breasts became noticeably asymmetrical, and now, with my second child, it has become significantly worse. Will Tricare cover a breast augmentation based on this?
Will Tricare Cover Breast Augmentation for Asymmetry Following a MRSA Infection?
Doctor Answers 5
Insurance Coverage for Asymmetry
I would suggest that you contact your physician to determine how much damage was caused by the MRSA. I would then contact a reputable board certified plastic surgeon to determine your treatment options. A letter should be written to your insurance company for pre-certification prior to having any procedure. Best of luck!
You need to ask your insurance company
You breasts are very different in size and shape and the solution is not augmentation only. You will need lift and fat grafting to the right breast for symmetry and lift only for the Left breast.
The insurance coverage will depend on the coverage and company.
Whether or not your health insurance will cover the procedure depends on the wording of the policy. If you were born this way it is doubtful that they would. If there is a clause in your policy stating they cover deformities arising from infections or trauma and you can prove the breast asymmetry was not there before the infection they will have to cover it. However their coverage will then be limited to getting you closer to what you were before the infection. You will need to have your surgeon write a letter of pre-authorization to the insurance carrier and describe your situation accurately. If they respond affirmatively you could then proceed with surgery paying less out of pocket.
I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.
My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.
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Ask the insurance company
It is your insurance company, ask them. In my experience, insurance covers very little that can be deemed cosmetic.
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.