will Medicare pay for removal of old silicone breast implants? They are 30 years old and am having hardness and pain.

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. 
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

Thank you for your question.  Sorry to hear that you are having troubles.  Please contact your local Medicare 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 Medicare will determine if it is medically necessary.  If they determine that it is medically necessary they will cover the procedure.  They typically do not cover implant issues if placed for cosmetic reasons.  You have a better chance with coverage if they were placed for reconstruction or, if they are ruptured gel implants placed before 1992, (old style silicone).   The other issue is that Medicare does not give pre-approval, so the decision of coverage is made after the operation is done.  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

Thanks for your question. Medicare often will cover the cost of implant removal but not the replacement. The capsule is the thickened scar tissue that forms around the implant and over time with older implants can become painful. The problem is that Medicare does not preapprove anything. Best of Luck!