Will Medicaid Pay from Saline Breast Implant Removal?

Question

I had breast augmentation under the muscle in 1998 with saline implants. For the past 5 years or so I've been having pain and discomfort in my breast and nipples, back & shoulders. I don't sleep well because of the discomfort & the implants will "travel" under my armpits if I lay on my back. Also if I bend over and use my pectoral muscles for anything they stay painfully contracted for a minute until they relax & the implant drops down. Would I qualify for medicaid to remove them? Thanks.

Michelle Spring, MD, FACS · Answer

The only way to know for sure is to visit with a qualified surgeon who contracts with Medicaid insurance.  He or she can help you understand your options and if surgery would be covered by your insurance.  Most of the time, cosmetic implant-related surgery is not covered by insurance - Medicaid or other.

Jed H. Horowitz, MD, FACS · Answer

Good day! Any insurance might not cover explantation because it is considered as a cosmetic procedure, not a medical necessity. More so with your history of breast augmentation. They may, however, consider covering the procedure if there is a legitimate medical reason that your doctor should be able to diagnose.
It is best to have an in-person examination so that costs will be customized according to your needs. You may also ask the manufacturer of your implant if explantation is covered in their warranty or insurance that you paid when you got them. Best of luck! #RealSelf100

Jeffrey J. Roth, MD, FACS · Answer

Thank you for your question.  Sorry to hear that you are having troubles.  Please contact your local Medicaid 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 Medicaid will determine if it is medically necessary, if so they will cover the procedure.  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

Tom J. Pousti, MD · Answer

I'm sorry to hear about the problems you are experiencing after breast augmentation surgery.

	Your best recourse would be to visit with board certified plastic surgeons ( you will have to do some research to  find doctors who work with Medicaid). Only after direct consultation, will you be able to have some indication whether removal of your breast implants would be considered “medically necessary”; even then it may be difficult  obtaining “authorization” for this procedure from any type of third-party entity.

	 Best wishes.

Jourdan Gottlieb, MD · Answer

Many Hospital websites were list the insurance carriers accepted by members of the medical staff including plastic surgeons. Your local Medicaid office is likely to have a listing of plastic surgeons that accept Medicaid.

	Finding such  a plastic surgeon would be the first step. that will be up to the Medicaid office to decide whether they considered this medically necessary.

	Thank you for your questio,n best wishes.

Will Medicaid Pay from Saline Breast Implant Removal?

Answers (6)

Answer: Removal of Breast Implants and Medicaid?

Answer: Removal of Breast Implants and Medicaid?

Answer: Will Medicaid Pay from Saline Breast Implant Removal?

Answer: Will Medicaid Pay from Saline Breast Implant Removal?

Recommended reading

Everything you need to know about Breast Implant Removal

Our mission is to create a world where every investment in modern beauty is Worth It.

Will Medicaid Pay from Saline Breast Implant Removal?

Answers (6)

Answer: Removal of Breast Implants and Medicaid?

Answer: Removal of Breast Implants and Medicaid?

Answer: Will Medicaid Pay from Saline Breast Implant Removal?

Answer: Will Medicaid Pay from Saline Breast Implant Removal?

Browse related questions

Recommended reading

Everything you need to know about Breast Implant Removal

Our mission is to create a world where every investment in modern beauty is Worth It.