Would board certified plastic surgeon take Medicare for explant?

Medicare will only cover medically necessary procedures. An explant does not necessarily qualify unless a medical necessity can be proven. Capsular contracture and rupture are indications for removal. This will not, however, include cosmetic procedures such as replacement or mastopexy.Once a medical necessity has been documented, you can seek out referral to a board certified plastic surgeon who participates with Medicare.As always, discuss your concerns with a board certified plastic surgeon (ABPS).Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic
Surgery, American Society of Plastic Surgeons
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In general, Medicare's benefits apply to medically necessary treatment for covered conditions. If your breast implants must be removed because the outer shell has broken, there is an infection or it prevents treatment for breast cancer, it may qualify for Medicare coverage through Part A. Await the results of your tests, and then phone several board certified plastic surgeons' offices to ask the patient coordinator whether Medicare reimbursement for implant removal is accepted. Care Credit and Alphaeon may allow you to finance the surgery if Medicare does not cover.

Dear mareallyself,
Every plastic surgeon has his own policy regarding payment. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only that way you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

The current FDA recommendation for silicone breast implants is an MRI at three years post implantation and every two years thereafter. Unfortunately, insurance carriers frequently do not cover the scan.
That said, severe capsular contracture is definitely an indication For either implant removal and capsulectomy or implant exchange and capsulectomy. This procedure is performed by fully trained plastic surgeons including board-certified surgeons. Please check with the individual office or Hospital department of plastic surgery to check your coverage prior to your consultation. The office staff should be able to direct you accordingly.

Medicare will only cover procedures that are medically necessary. Ask your primary care doctor to refer you to a board certified plastic surgeon in your area for an evaluation. Medicare will not cover any cosmetic procedure following the explant, such as a lift or replacement of the implants.Best of luck!

Hi there!  I am so sorry to hear about the severe capsular contracture and pain that you are experiencing.  I would encourage you to call Medicare and see if there are any contracted board certified plastic surgeons in your area.  I wish you my best.

I would suggest finding a board certified plastic surgeon in your area who accepts Medicare. Most surgeons who do take Medicare will remove old ruptured gel implants. If the mammagram and/or ultrasound show a rupture, you probably will not need a MRI.

Medicare will cover the removal of the implants if it can be shown that it is medically necessary.  Your test results should reveal whether the implants have ruptured.  If so, you may have coverage for removal.  At that time you can get a referral from your treating physician for a board certified plastic surgeon near you.  Please be aware that a breast lift, implant replacement, or any other procedure that is considered cosmetic will not be covered by insurance.