Will Medicare pay for implant removal?

Thank you for your question.  Sorry to hear that you are having troubles.  Please contact your local Medicare office.  They will tell you the Board Certified Plastic Surgeons that are on their panel.  I would then see the Plastic Surgeon.  They can submit the case and Medicare will determine if it is medically necessary.  If they determine that it is medically necessary they will cover the procedure.  They typically do not cover implant issues if placed for cosmetic reasons.  You have a better chance with coverage if they were placed for reconstruction or, if they are ruptured gel implants placed before 1992, (old style silicone).   The other issue is that Medicare does not give pre-approval, so the decision of coverage is made after the operation is done.  Best to see an experienced, Board Certified Plastic Surgeon.  Together you will work out a plan.Jeffrey J. Roth, M.D., F.A.C.S.Board Certified Plastic SurgeonLas Vegas Plastic Surgery

Thank you for your question.  The answer will really depend on the reason for implant placement.  If they were placed for cosmetic reasons, you may have trouble with Medicare covering the removal.  If you are having issues after breast cancer reconstruction, then Medicare should cover the removal.  The problem with Medicare, is that they will not give your doctor's office a pre-approval/pre-determination prior to surgery like a commercial insurance would.  So with Medicare, you go into surgery with no guarantee of payment.  It is very frustrating for both doctors and patients.  Good luck. 

Removal of implants placed for cosmetic reasons is generally not covered by Medicare.  The exception is coverage is sometimes extended if the implant is the old style of silicone implant that has ruptured. If you had them placed due to reconstruction or other causes coverage should be provided.

Medicare typically does cover removal of old ruptured gel implants, the type used before 1992. Medicare will also cover removal of implants done for reconstruction. However, Medicare does not give prior approval, and the claim would have to be filed after surgery to see what Medicare will do.

If the implants were placed for cosmetic reasons, it is doubtful that they will cover the explant surgery.