If you’ve decided to get breast augmentation surgery, there are a few things to think about, including which type of implant and size will work best for you, as well as choosing the ideal plastic surgeon in your area. Finding out if your insurance will cover your breast augmentation treatment is another crucial step. Before undergoing any type of plastic surgery, it’s critical to have a full idea of the costs involved. Breast augmentation is typically considered elective surgery and is therefore not covered by insurance. Breast reconstruction surgery including breast implants, on the other hand, may be reimbursed in full or in part.
Before scheduling your treatment, it is a good idea to educate yourself about the specifics of your plastic surgery and your insurance coverage.
Cosmetic vs. Medically
When it comes to plastic surgery, the insurance company determines whether the procedure is cosmetic or medically required, and this determination may vary over time. The following are some of the reasons why your insurance plan may change your coverage:
- The type of insurance a patient has can change with newly implemented policies or a new insurance provider
- Evolution of new medical treatments or new procedures
- Medical research and how it relates to patient needs can affect insurance policies
To distinguish between aesthetic surgery and medically essential (or reconstructive) surgery, most insurance companies use surgical definitions published by the American Society of Plastic Surgeons (ASPS) and the American Medical Association (AMA). To put it another way, they decide if something is medically necessary or completely optional. Breast augmentation, for example, is classified as cosmetic surgery since breast implants will enhance and alter the body to improve a patient’s appearance. Reconstructive surgery is used to treat breast deformities caused by trauma, sickness, infection, tumors, or developmental issues. When breast implants are required to restore breast function or provide a patient with a healthy appearance, insurance companies may fund the treatment entirely or partially.
Important Questions to Ask Your Health Insurance Company
- Will any of the costs of breast implant surgery be covered?
- Will my insurance rates or coverage be affected if I have breast implants?
- Will the necessary treatment or surgery be reimbursed if I develop health problems as a result of my breast implants?
- Will having breast implants affect my insurance coverage if I have breast cancer or other breast issues later on?
- Will any diagnostic testing, such as MRIs or further mammogram images, that I might need after obtaining breast implants be covered?
Get your responses in writing, and check up with your insurance company every few years to see whether its policy has changed.
Will my breast implants be covered by insurance?
Breast implants to enhance or alter a patient’s appearance for simply cosmetic reasons are often not covered in the majority of situations, therefore individuals are responsible for paying for their procedure. In terms of insurance coverage, exceptions are made depending on why a patient is receiving breast implants. Most insurance companies will cover breast implants that require reconstruction due to a medical issue such as breast cancer, Poland’s syndrome, trauma, or infection. Patients thinking about getting breast augmentation should check with their insurance company to see if they are covered.
Additional Breast Implant Surgery Costs
If you’re looking at breast implant prices for cosmetic reasons, keep the following in mind:
- Surcharges for additional services at the time of surgery. Inquire with your doctor about all costs, including implant placement, anesthesia, hospital fees, medication, and any additional expenditures. Some surgeons charge a flat price that covers everything. Others, however, do not.
- Surgeries will be performed again. Breast implant recipients almost always require further surgery at some point. Some women require immediate further surgery. They may, for example, develop an adverse reaction or wish to change the implant’s position. Others may need to have their original implants replaced after a few years. Breast implants, like other medical equipment, do not endure indefinitely. Some implant manufacturers provide lifetime warranties. If the implant fails, the business will provide a free replacement. However, double-check the specifics. The surgery or other costs may not be covered by the guarantee. It’s important to keep in mind that removing breast implants can be more expensive than putting them in.
- Diagnostic testing is a term that refers to the process of Women with silicone breast implants should get an MRI three years after implantation and then every two years after that, according to the FDA. The only method to ensure that the silicone implant hasn’t ruptured is to do so. These tests are not required for women who have saline implants. MRIs can be costly. In the United States, an MRI costs around $2,000 on average.
If you’re thinking about getting plastic surgery, do your research and figure out how much you can afford. Verify the cost of your breast augmentation at your consultation, including your surgeon’s charge, anesthesia, and any operation facility fees.