Can Breast Augmentation Be Covered By Insurance

Regardless of your reasons for desiring breast augmentation surgery, you want to inform yourself about the cost.

Many factors go into a surgeon’s pricing for the procedure, including his or her experience, the type of augmentation, and what part of the country the medical office is located in.

Patients often want to know if insurance can cover their breast augmentation surgeries.

According to the American Society of Plastic Surgeons, most health insurance plans will not cover cosmetic breast augmentation costs, related complications or revision surgery.

However, there are circumstances in which your insurance will pay. If your surgery is considered reconstructive rather than cosmetic, it may be covered.

Breast Augmentation
Breast Augmentation: Photo source (Healthline)

COSMETIC BREAST AUGMENTATION

Cosmetic surgery involves augmentations performed solely for appearance’s sake.

If you’re considering breast augmentation to enhance your appearance in a swimsuit, your surgery falls into the cosmetic category.

Other examples of cosmetic surgeries include nose jobs done to reduce the size of the nose; other implants, like chest or calf; and anti-aging facial treatments, like a facelift.

There are many valid reasons you may seek any of these surgeries, and you have many options to choose from.

But if they have no medical purpose, then insurance will not cover them.

Reconstructive Breast Implant

If medically necessary, breast implant is considered breast reconstructive surgery.

Coverage varies by insurance and includes mastectomy-related cases.

Evolving Definitions

The definitions of cosmetic and reconstructive surgery are evolving.

This includes matching the appearance of both breasts after mastectomy.

Insurance can cover elective revision surgery for aesthetic reasons, but it varies.

Some cover revisions up to eight years after initial reconstruction, others for a shorter time.

Patients should work with their insurance to determine coverage.

LIFETIME WARRANTY

Many breast augmentations have a “lifetime warranty.”

If insurance finds faulty implants, it covers replacements, and manufacturers frequently cover implant replacement and some operating room expenses for up to 10 years.

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