Mastectomy 15 years ago with a tram flap reconstruction. Now, Cancer in Other Breast.

I had a mastectomy 15 years ago on the left breast and had reconstruction with a tram flap the same day. Now i have been diagnosed with breast cancer on the right side. Will the insurance allow me to have the left breast that had the tram removed or reduced

Doctor Answers 7

Both Breasts Covered by Insurance following Breast Cancer Surgery

Both breasts are covered by insurance for needed reconstruction by law.

Here are the facts:

Women's Rights for Breast Reconstruction  Following Mastectomy

The Federal Women's Health and Cancer Rights Act of 1998 is still the law today

Under the federal Women's Health and Cancer Rights Act of 1998, a yearly notification
of your benefits pertaining to breast reconstruction must be sent to you by your insurance company.
The Women's Health Care Act states that benefits must be provided for:
Reconstruction of a surgically removed breast
Surgery and reconstrcution of the other breast to produce a symmetrical appearance
Prostheses and treatment for physical complications from all stages of a mastectomy, including lymphedema

These benefits are subject to the conditions and terms of your plan, including maximum benefit amounts, deductibles,
copayments, and coinsurance provisions. The benefits are subject to your plan's exclusions and limitations.

Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

Reconstruction for breast cancer is always covered

Reconstruction for breast cancer is always a covered benefit under your insurance plan. Even though this is usually very clear cut, I always contact the insurance company ahead of time to get these types of procedures pre-authorized.

Kevin Brenner, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 22 reviews

Mastectomy 15 years ago with a tram flap reconstruction. Now, Cancer in Other Breast.

Yes, it is a revision of reconstruction to attain symmetry of your breasts. There should be no insurance issue, they will pay. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Breast reconstruction

Breast reconstruction should be covered by yoru insurance company.  This is a fedral mandate. If your surgeon does not accept insurance as payment, then you would have to pay out of pocket as well.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Breast reconstruction

The a federal laws that require all surgery for breast reconstruction to be covered. There are a number of options available to you. Reconstruction of the right breast with either a tissue expander and then an implant or the use of a latissimus with implant are both possible. You need to discuss you goals with you surgeon to determine a best treatment plan.

David L. Abramson, MD
New York Plastic Surgeon
4.1 out of 5 stars 12 reviews

Breast Reconstruction

YES you can have a new breast reconstruction

You can have revision of breast reconstruction.  these are federally mandated , and all insurance co, must abide

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Breast reconstruction

Three basic forms of breast reconstruction exist. You can use your own tissue, implants or a combination of the previous two techniques. Your own tissue can be used in the form of the DIEP flap, PAP flap, SGAP flap or fat grafting. Implants can be done in one stage or two stage. Two stage reconstructions are started by placing expanders at the time of mastectomy. Once they expanders are placed they are able to be inflated as determined by wound healing. The final time consists of combining any of the above techniques.

If you are interested in being seen in Austin please give us a call. I know this is a difficult time for you. The majority of my practice is devoted to reconstruction for women with breast cancer or who are BRCA+

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.