Impact of Cosmetic Breast Implants on Insurance Coverage

I have read that if your medical insurance finds out that you have breast implants (for cosmetic reasons) they may: drop you from coverage, increase your premiums, &/or deny any breast-related problems you may incur throughout your lifetime.

This doesn't seem reasonable. Doctors, have you seen these types of insurance problems happen to women with cosmetic breast implants?

Doctor Answers 3

Insurance and breast surgery

Yes, there are insurance companies taht have certain riders that may impace your ability to be covered for certain medical conditions that could be related to your implants like infection, rupture, capsular contracture, to name a few.  Check with your carrier.

New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Health Insurance and breast implants

You are correct. Depending on your insurance plan, the presence of breast implants may effect your coverage in one of many ways including a rider excluding coverage of any breast related disease, or increase in your premium.

We, as a society definitely agree with you, but have had little success changing this policy. It seems unfair to us that an insurance company will cover complications of dangerous habits such as smoking or irresponsible behavior such as injuries from driving drunk.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 82 reviews

Breast implants and insurance coverage

I agree that this is completely unfair and somewhat discriminatory against women, but some insurance companies do have this policy. I have not had any patients in my practice complain of this, but you should check with your specific carrier about this issue.

Some insurance companies will pay, however, for you to have the implants removed if there is a problem, but they will not pay to have them replaced. Again, it varies from one insurance company to another, so I suggest checking prior to your augmentation surgery. Good luck, /nsn.

Nina S. Naidu, MD, FACS
New York Plastic Surgeon
4.7 out of 5 stars 14 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.