Would Medicaid pay for breast implants if one boob is a cup size bigger then the other one?

Question

My breast have gotten bigger from taking risperdal & now my right boob is at least a cup size bigger then the left one. This causes my bras not to fit properly. Would Medicaid pay to have this fixed?

Robert Kearney, MD, FACS · Answer

No Medicaid will not pay for that surgery as it is largely cosmetic. If you require reconstruction then you can get it pre approved through Medicaid.

Christopher J. Davidson, MD, FACS · Answer

In my experience, few insurance companies are willing to pay for one cup size of breast asymmetry.  Best of luck.

Kenneth Hughes, MD · Answer

That would be extremely unlikely.  If it did pay, the reimbursement would likely not be enough to cover the costs of the plastic surgeon performing the surgery.Find a  plastic surgeon with ELITE credentials who performs hundreds of breast  augmentations each year.  Then look at the plastic surgeon's  website  before and after photo galleries to get a sense of who can  deliver the  results. 	Kenneth Hughes, MD Los Angeles, CA

Miguel Delgado, MD · Answer

Unfortunately there probably isn't any insurance company that will cover your asymmetry as it is not considered medically necessary. Breast reduction surgeries are sometimes covered when they cause physical pain, even then it can be hard to get approval. Find a Board Certified Plastic Surgeon that specializes in breast surgery to help you find options such as financing. Good luck!

Curtis Wong, MD · Answer

may be covered but I would speculate they would prefer to cover a reduction of the side the grew rather then provide you with implants.  You would need to find a provider and pursue through their office if they feel you have medical reasons that would allow for this.

Tom J. Pousti, MD · Answer

I do not have any experience with Medicaid paying for the type of surgery you are describing. Ultimately, you will need to be careful with the selection of your plastic surgeon.You may be best off gradually saving for the procedure and having it performed by the plastic surgeon who can demonstrate the most experience achieving the types of results you are looking for, as opposed to a plastic surgeon who will perform the procedure covered by a specific "insurance". Best wishes.

Donald Nunn, MD (retired) · Answer

Insurance will not pay for asymmetry unless the condition is due to cancer, congenital malformation or tramatic defect.  Cosmetic surgery is not covered.  Donald R. Nunn MD  Atlanta Plastic Surgeon.

Would Medicaid pay for breast implants if one boob is a cup size bigger then the other one?

Answers (7)

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