Will Medicaid Cover Breast Surgery After Pregnancy?

Question

I had kids and my boobs changed. One is bigger than the other and they sag a lot and the nipples are very deformed.I wanted to see if I can get medicaid to help with my breast? Is there any help out there for this?

Sam Jejurikar, MD · Answer

Hi Roxy,
Although you describe your breasts as "deformed", virtually all insurance plans consider sagging and droopiness to be cosmetic problems.  Insurance companies, including government-sponsored programs such as Medicaid or Medicare, do not cover cosmetic procedures.  If it bothers you tremendously, many plastic surgeons participate with third-party financing companies to help make surgery more affordable.
Hope this helps.  Best of luck.

Brian K. Reedy, MD · Answer

Thanks for your question.
Medicaid and other health insurances will not cover a breast augmentation surgery. It is considered a cosmetic/ self pay procedure. Schedule a consultation with a board certified plastic surgeon to discuss your options. Best wishes!

Jerome Edelstein, MD · Answer

You will have to consult your insurance provider to find out if your breast surgery is covered. However, in general, the answer would be no unless it would resolve a physical impairment directly caused by your asymmetrical breasts, and breast augmentation or a breast lift is proven to be the most suitable treatment for you.

Otto Joseph Placik, MD · Answer

Medicaid will rarely cover any breast surgery other than breast cancer reconstruction following cancer, in my limited experience.

Farbod Esmailian, MD · Answer

This would be considered cosmetic surgery and insurance companies do not cover cosmetic procedures.  In fact some insurances would go as far as not to cover any complications that can occur from cosmetic procedures.
Hope that helps.

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