Does Medicare cover Breast reconstructive surgery after bilateral prophylactic Mastectomy for patients with BRCA positive gene mutation and strong family hx (medical history) of breast cancer?
Does Medicare Cover Breast Reconstruction After Mastectomy?
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Doctor Answers 13
Insurance is required to cover breast reconstruction
Medicare and breast reconstruction
Yes Medicare covers breast reconstruction!
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Breast reconstruction after mastectomy
Yes. The Women's Health and Cancer Rights Act of 1998, mandates that health insurance covers the reconstruction for a mastectomy. You do not have to be diagnosed with breast cancer . Many women now have risk reduction mastectomies due to a strong family history or a genetic mutation.
MEDICARE AND COVERAGE FOR BREAST RECONSTRUCTION
Be well and good luck!
Medicare and breast recon?
Yes! Under federal law it is covered. Also, any asymmetry is also covered to balance the breasts.
Insurance implications with breast reconstruction
On October 21, 1998, the Women's Health and Cancer Rights Act of 1998, became effective as part of the 1999 Omnibus Consolidated and Emergency Supplemental Appropriation Act. This new federal law requires group health plans and individual health policies that provide coverage for mastectomies to also provide coverage for breast reconstruction in connection with mastectomy.
In accordance with the Women's Health and Cancer Rights Act of 1998, members receiving mastectomy-related services are entitled to the following benefits:
Reconstruction of the breast on which mastectomy has been performed
Surgery and reconstruction of the other breast to produce a symmetrical appearance
Prostheses and treatment of physical complications at all stages of the mastectomy, including lymphedemas
One home health care visit within 48 hours of hospital discharge
Outpatient care following a mastectomy performed in a health care facility
Inpatient skilled nursing facility care in which the length of stay is determined by the treating physician based upon generally accepted criteria for safe discharge
This coverage will be provided in a manner determined in consultation with the attending physician and patient, given that your plastic surgeon accepts your insurance.
Medicare Covers Breast Reconstruction after Mastectomy
It is a federal law that Medicare and all insurance companies cover costs for mastectomy and subsequent reconstruction
Breast reconstruction and Medicare
All insurance companies will cover breast reconstruction after mastectomy. Medicaid will covet this for you.
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.