Does Medicare cover explant?

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.

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