Will health insurance cover MRI for 3year old gel implants if you think something is wrong with them?

Question

I got implants 3 years ago. My left breast has became a lot softer, and doesn't seem to have as much upper fullness as my right breast. I'm also getting a burning sensation it feels like it's behind the nipple.(it's not everyday) so my PS told me at 3 years get an MRI, do I go to my PS and tell him about what's going on and get a script for the MRI? And will insurance cover it since something seems to be going on

Stephen T. Greenberg, MD, FACS · Answer

Thank you for your question.  Insurance coverage for an MRI of the breasts to check the integrity of a patients breast implants will vary by carrier and plan.  Please contact your insurance company to see about coverage.  I would recommend following up with your operating board certified plastic surgeon for an evaluation and to address your concerns.

Michele A. Shermak, MD · Answer

Oftentimes it is hard to get insurance to cover MRI to assess breast cancer! I know, hard to believe! MRI is rarely covered to assess a cosmetic breast augmentation. But you can certainly try!If you are in an age range where you should undergo breast surveillance or have a significant family history for breast cancer, then you may qualify for MRI to get an accurate assessment of your breasts. Typically if you are concerned only about the implants, the exam is clear cut and women just get the implant and scar tissue removed.It is recommended the implants be removed if they are ruptured. If you are uncertain, ultrasound is a good first study. And you should meet with a board certified plastic surgeon to help (plasticsurgery.org)Best of luck!

Nelson Castillo, MD · Answer

Thank you for sharing your question and I am sorry to hear of your breast implant issues.  If your implants were placed for aesthetic reasons instead of reconstructive it is unlikely that your insurance company would cover the cost of the MRI.  Hope this helps.

Kenneth Hughes, MD · Answer

MRIs are recommended for patients with silicone gel implants starting 3 years after surgery and yearly thereafter.  The MRI will expose signs of a rupture that you cannot detect from the outside. My experience has been that this expense is not covered by insurance. Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Steven Wallach, MD · Answer

My experience is that if the original surgery was a a cosmetic procedure, then it is unlikely your insurance will cover it, but you can check with your insurance company.

Will health insurance cover MRI for 3year old gel implants if you think something is wrong with them?

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Answer: Will health insurance cover MRI for 3year old gel implants if you think something is wrong with them?

Answer: Will health insurance cover MRI for 3year old gel implants if you think something is wrong with them?

Answer: MRI with implants

Answer: MRI with implants

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Everything you need to know about Breast Implants

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Will health insurance cover MRI for 3year old gel implants if you think something is wrong with them?

Answers (6)

Answer: Will health insurance cover MRI for 3year old gel implants if you think something is wrong with them?

Answer: Will health insurance cover MRI for 3year old gel implants if you think something is wrong with them?

Answer: MRI with implants

Answer: MRI with implants

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Recommended reading

Everything you need to know about Breast Implants

Our mission is to create a world where every investment in modern beauty is Worth It.