Does Medicare cover explant?

Thank you for your question.   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

hello sue ann mckinney Health insurance companies generally do not cover cost of cosmetic surgery. You can talk to your plastic surgeon about a payment plan #medicare #cost

Thank you for your question. Insurance will not cover any cosmetic procedures. Insurance will cover if the procedure is medically necessary. This procedure would be considered cosmetic. Best of luck. Dhaval M. Patel Double Board Certified Plastic Surgeon Hoffman Estates Barrington Oakbrook Chicago Orland Park 

Insurance does not cover any procedure relating to cosmetic surgery.  If you had implants as part of a formal breast reconstruction for cancer then insurance will pay to have them removed, but otherwise they will not cover the cost of removal.  Implants can be removed under local anesthesia in many instances and that may help to decrease the cost significantly.

There are very specific cases where Medicare may cover removal of breast implants.  If the condition is related to breast cancer, or if there is a rupture of the old silicone implants coverage may be provided.  In most cases however, it is not a covered benefit.

If you still have the old gel implants from before 1992, and they are ruptured, Medicare typically does cover removal of the implants and capsules. If you received implants after reconstruction for breast cancer, Medicare does cover removal and even replacement. Otherwise, the procedure is considered cosmetic, since done for cosmetic reasons, and no insurance company covers removal.

Medicare, as well as other insurance companies do not cover explant surgery unless you are a breast cancer patient.  On average, insurance companies do not pay for cosmetic surgery.