The fat would be harvested from thighs since I have very little on the abdomen. Does the harvesting donor site matter for insurance purposes? Do other insurance carriers pay for this procedure? Can the fat transfer be done in a revision procedure and will it be covered by Medicare?
January 13, 2016
Answer: Preauthorization Most insurance carriers offer the ability for the doctors office to preauthorize a procedure so that you know you are getting a covered benefit. Medicare does not provide for this process. Generally speaking, procedures to reconstruct a breast from "acquired breast absence" as well as procedures on the opposite breast to achieve symmetry and revision procedures needed are a covered benefit. One caveat is that some insurance carriers have recently been denying procedures after the initial reconstruction is performed. Unfortunately, it gets complicated and is ever changing, especially since all the insurance rules and coverages are in a state of flux! Good luck and look for a surgeon that is a good patient advocate!
Helpful 1 person found this helpful
January 13, 2016
Answer: Preauthorization Most insurance carriers offer the ability for the doctors office to preauthorize a procedure so that you know you are getting a covered benefit. Medicare does not provide for this process. Generally speaking, procedures to reconstruct a breast from "acquired breast absence" as well as procedures on the opposite breast to achieve symmetry and revision procedures needed are a covered benefit. One caveat is that some insurance carriers have recently been denying procedures after the initial reconstruction is performed. Unfortunately, it gets complicated and is ever changing, especially since all the insurance rules and coverages are in a state of flux! Good luck and look for a surgeon that is a good patient advocate!
Helpful 1 person found this helpful
