Is the Cost of Alloderm Passed on to the Patient?

The use of alloderm acellular matrix has in my opinion revolutionized breast reconstruction after mastectomy, by providing better support and coverage of the implant with less invasive surgery and more control over the shape of the breast. Breast reconstruction is a federally mandated insurance benefit and this would cover the implants and materials used.

It is a different story with revisions of breast augmentation. The material most often used here is Strattice, but insurance normally doesn't cover issues related to cosmetic surgery. However, for certain problems the use of a graft such as Strattice can prevent a lot of more expensive problems and additional surgery down the road.

For reconstructive cases, insurance will take care of fees of supplies associated with surgery (there is normally a "patients responsibility' portion - differs with each insurance). For cosmetic procedures that are not covered by insurance, the cost of using allograft is passed onto the patient.

When Alloderm is used for breast reconstruction, it is often covered by the insurance companies. Most of the larger insurance companies include Alloderm in their coverage policies. Depending on your insurance company, they may cover any "dermal matrix" or only cover specific named products (such as Alloderm). This is important to discuss with your surgeon and to review with your insurance policy.

For cosmetic procedures, Alloderm (or the equivalent Strattice) is paid for by the patient just as the cost of the implants is passed on. Some surgeons may include these costs in their surgical fee. It is important to have this discussion prior to undergoing surgery and should be on the quote you are given from your surgeon.

Although in today's healthcare environment it is impossible to know for certain whether or not insurance will cover procedures, breast reconstruction after mastectomy is usually covered. Alloderm is usually covered as well when used for this purpose.
Best Regards.

In breast reconstruction, Alloderm may be part of the reconstructive procedure and should be covered by your insurance.  The costs of the Alloderm should not be passed to the patient.