Insurance Coverage for Lift and Implants for Deformed Breasts?

After having 3 children and losing the weight before even leaving the hospital, my breasts are very deformed and I am unable to find a bra or bathing suit to even fit properly. I weighed about 160 pounds per child then returning to 100-110 pounds. There is just no way to keep them in a bra. Is it possible to get breast implants and breast lift through insurance coverage for this?

Doctor Answers 17

Insurance for Implants

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Dear Itsme79

Unless you have a Mercedes Benz type of plan I know of no insurance that will pay for breast lift with implants as a result of having children. If you have a Health Savings Account some of them allow the money to be used for cosmetic surgery. The only time I know of insurance covering the cost of implants is for breast reconstruction after mastectomy and a symmetry procedure for the opposite side.

If finances are a major concern you might want to try calling the medical school and teaching hospital in youor area and asking if they have a plastic surgery residency program. The residents will operate on you at a marketly reduced rate under the direct supervision of an attending senior plastic surgeon.

Good Luck, Steven Schuster MD FACS

Insurance Coverage for Lift and Implants for Deformed Breasts

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Coverage provisions are specific to your plan. Therefore, you would need to call for details In almost all situations, insurance would deem a breast lift as a cosmetic procedure, and would not provide coverage. 

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Insurance coverage for breast surgery

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A breast lift repositions your existing breast tissue to a more youthful shape while a breast reduction removes volume and at the same time lifts the breasts. A breast lift is considered cosmetic surgery while a breast reduction is considered medically necessary if you meet the criteria of your insurance company concerning the amount of breast tissue removed combined with symptoms such as back, neck and shoulder pain, rashes under the breasts and breast pain.

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Probably not

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Unfortunately, insurance won't cover your surgery unless you have medical issues directly caused by your saggy breasts. But just to make sure, you can always ask your provider.

Usually insurance doesn't cover breast lifts

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Insurance doesn't usually cover the cost of a breast lift, however you should contact your insurance provider to find out if yours is covered. If it is, it would have to be deemed medically necessary.

Insurance Usually Does Not Cover Breast Lift With Implants

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         Unfortunately, breast augmentation and mastopexy are both considered to be cosmetic procedures by insurance companies. Under these circumstances, coverage would be denied and payment would be the patient’s responsibility. 

Insurance coverage

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I agree with the other doctors.  In my area, insurance does not cover the cost of the surgery that you need. 

Shim Ching, MD
Honolulu Plastic Surgeon
4.6 out of 5 stars 51 reviews

Cost and insurance for breast lift

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Cost is geography dependent. In Florida it runs $8000-10000. More important than price is safety and experience. Also, as an aside, breast lift, has never been a covered procedure with any insurance carrier unless it is to match a breast reconstruction for breast cancer.

Implants and insurance coverage

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In my experience, insurance covers  only procedures that are medically necessary.  Breast implants and lifts are usually elective procedures and not covered by insurance.


Breast Augmentation/Mastopexy and Insurance?

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The breast augmentation/mastopexy procedure is considered a medically unnecessary/cosmetic procedure regardless of the causes of the breast hypoplasia/ptosis. Therefore, the procedure will not be covered by health insurances.

Best wishes.

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.