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The single most important factor in your cosmetic (aesthetic) plastic surgery journey is the surgeon you select. It’s surprising to learn that some doctors performing cosmetic surgery today have had no formal surgical training. Asking the right questions now before you schedule a consultation is your best bet to receive the quality outcome you desire.
Will insurance cover breast reconstruction or is it considered cosmetic?
Breast reconstruction is no longer considered cosmetic surgery. Thanks to "The Women's Health and Cancer Act of 1998," group health plans, insurance companies, and HMO's that offer mastectomy coverage also must provide coverage for reconstructive surgery after mastectomy. The law dictates that this coverage includes reconstruction of the breast removed by mastectomy, reconstruction of the other breast to produce a symmetrical appearance, breast prostheses, and treatment of physical complications at all stages of the mastectomy, including lymphedema. A federal standard has been set by this law so that women can obtain breast reconstruction following mastectomy even if they live in states that do not require insurance companies to provide this coverage.
In many cases, reconstruction to correct a lumpectomy site will also be covered by insurance. It is important to check with your individual insurance provider to find a surgeon in your network that meets your reconstruction needs. If your insurance carrier denies approval to have the type of chemotherapy or reconstructive surgery you want, with a specific surgeon of your choice, you can appeal. Office staff will be able to help you in this process.
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