I need breast implants removed. Is there a way to get medicare/Humana and Blue Cross Blue Shield to pay?

Question

Camille Cash, MD · Answer

Typically implant removal is not covered by insurance.  Sometimes there is an exception for older silicone implants that have ruptured.  The best way to determine if you have coverage is to contact your insurance carrier.  If you are not having issues with your implants you may be able to have them removed under local anesthesia in the office to save on costs.

Jeffrey J. Roth, MD, FACS · Answer

Thank you for your question.   Please contact your local Medicare office.  They will tell you the Board Certified Plastic Surgeons that are on their panel. I would also contact the Blue Cross/ Blue Shield office.   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.  Blue Cross/ Blue Shield may pick up the cost but the decisions are so variable as to not even guess.  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 Surgeon
Las Vegas Plastic Surgery

Gary Lawton, MD, FACS · Answer

Typically the insurance companies pay only  for surgeries that are related to medically necessary conditions.

Connie Hiers, MD, FACS · Answer

BCBS does not cover removal of implants since they were placed cosmetically. Medicare may cover removal of old ruptured gel implants. If you had breast implants for reconstruction after cancer surgery, insurance does cover removal.

Andrew T. Cohen, MD, FACS · Answer

It is doubtful that an insurance company will pay to remove implants when they were placed for a cosmetic reason.  I would call your insurance company to find out.    Good luck.

I need breast implants removed. Is there a way to get medicare/Humana and Blue Cross Blue Shield to pay?

Answers (6)

Answer: Insurance

Answer: Insurance

Answer: Breast removal

Answer: Breast 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.

I need breast implants removed. Is there a way to get medicare/Humana and Blue Cross Blue Shield to pay?

Answers (6)

Answer: Insurance

Answer: Insurance

Answer: Breast removal

Answer: Breast 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.