Is It Possible to Have Insurance Cover Implant Explantation?

I had McGhan saline implants placed subglandularly in 2000. I've developed capsular contracture in my rt breast. Since 2006 I've suffered from terrible hair loss, itching skin, fatigue, joint pain. I've seen 3 doctors with all tests negative. Could the implants be the cause? I'm a RN, and I'm wondering if ins ever pays for explantation, or if there are any programs/studies to offset some of the cost. (The implanting dr is retired, so returning to him isn't possible.)

Doctor Answers 5

Insurance Coverage of Breast Implant Explantation?

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Unfortunately, it is very unlikely that health insurance companies will cover breast implant removal that were placed for aesthetic purposes. However, there is no way to know for sure without attempting.

Best wishes.

Removing breast implants

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Insurance coverage is different for every person, so you'll have to visit with a plastic surgeon for full assessment and insurance verification for this procedure.

Insurance and implant removal

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Insurance companies all have their own specific criteria for approving surgery. You should contact your insurance carrier and ask them what their policies are.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Insurance coverage for breast implant removal (explant)

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As stated by Dr. Pelletiere, each policy has its own provisions and do not consider explantation a covered benefit. However, you could contact your insurance carrier or have a plastic surgeon compose a predetermination of benefits letter to your carrier.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Insurance Coverage NOT Likely For Cosmetic Implant

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In general, most insurance companies will not cover anything to do with breast implants if they were placed for aestehtic reasons only, even if you are having pain from them now.  It does not hurt to undergo the pre-certifiation process, but I would not hold your breath for a positive response.  The chances of your implants causing your symptoms are extremely small.  The ten year core and adjunct studies done by both implant manufacturers ( Mentor and Allergan) were unable to find any symptoms or disease processes that were more prevalent in women with or without implants.  The same goes for all the European studies, as well as the 1997 Institutes of Medicine study.  That is not to say that something cannot go on, but it would be very rare.  I hope this helps.

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.