Reconstruction After Breast Cancer: Will Medicare Pay to Replace Ruptured Implants?

Question

I had breast cancer 23 years ago with reconstruction. My implants have been replaced once, 12 years ago, and these are now leaking. Will Medicare pay for replacement? I was not on Medicare when they were replaced 12 yrs. ago. I have no photos but had a breast MRI which showed the leakage.

Neil J. Zemmel, MD, FACS · Answer

All insurance companies, including Medicare and Medicaid, are mandated by law to cover all breast reconstruction procedures. This includes the primary surgery, implant exchange, symmetry procedures between breasts, and even nipple reconstruction and tattooing.  I would also recommend asking your surgeon about changing to a silicone implant.  These are very safe now and have a more natural feel and look.  I hope this helps.

	Kindest regards

	Neil J. Zemmel

Steven Wallach, MD · Answer

Medicare should cover your reconstruction related to breast cancer surgery.  This should not be a problem.

Chen Lee, MD · Answer

Medicare and private insurance cover must by law cover treatment for the reconstruction of a breast cancer patient.  This includes the opposite normal breast to obtain symmetry.

Chen Lee MD, MSc, FRCSC, FACS

David L. Abramson, MD · Answer

All post mastectomy reconstruction is covered by all insurances. This includes problems that may develop later on.

Tal T. Roudner, MD, FACS · Answer

Yes they should since you are a breast reconstruction patient. But contact them to make sure prior to any procedure!

	Good Luck

Reconstruction After Breast Cancer: Will Medicare Pay to Replace Ruptured Implants?

Answers (5)