IMPLANT REDO & INSURANCE

cookymkr

I hope that someone has an answer for this, here's my question. Anyone had to have their implants redone because the size was wrong and how was the issue handled by insurance?

Thank you in advance for taking the time to answer this.

Deirdre1

IF you can show that the difference between the breast needs attention, then you might have a chance at getting your insurance to pick up SOME of the charges.. I'm going through something along the same line myself.  Because there are now laws protecting women so that they can adjust the breast (and whatever that entails) to be more even, heal wounds and or redo sizing to make the breasts as similiar as possible.  If one breast look marketly different or if your fold is in a different place you have a chance.. They will challenge you so be prepared to challenge them back.  Get hold of a full print out of your health insurance policy and the law that pertains to mastectomy and breast reconstruction.  I have a copy of it somewhere so if I find it I'll tell you where you can get it, in the mean time you can try googling it try mastectomy + protection laws + breast reconstruction.  It's a matter of who will blind first and frankly how much insurance coverage you have... but almost all insurance companies will challenge you especially if it is within a year of exchange.  Good Luck and I know how difficult this is!  Best

cookymkr

i'm already fighting my insurance company over $20,000 worth of chemo drugs that denied coverage for...my employer might be changes insurance companies before we actually end up changing them out so we'll see...have to ask PS about how we do that.

abbadoodles

It depends upon the quality of your insurance and the circumstances.  Mine has covered everything including going from implant to MS free TRAM to additional implant and maybe will go on to additional flap.

cookymkr

abbadoodles: thanks for your information. My PLAN doesn't say anything about on one surgery. It states that it covers reconstruction following a mastectomy. If my surgeon isn't happy with the

1st surgery then I don't know why "revisions" couldn't be made. Afterall, isn't that why we pay those premiums?

have super fantastic day!

Deirdre1

Revisions SHOULD be covered - it's only if you decide to have some alternative work that can be considered "cosmetic" but even then if you ps writes it up as a necessary revision you will get it covered.. They will tell you on the phone you don't have covereage but have your ps call them directly!  Good luck!

NancySahlin

I have no breast on the left side AFTER recon.!

The implant became infected after 3 days and

after the silicone im. was replaced w/ the expander.

Then it was removed along w/my left pec muscle.

I pray my ins. pays

I pray something bad will happen to this doctor

He butchered me. I ask myself....

Why did he use a tissue expander? He knew I had radiation?!

He told me my skin LOOKED soft and supple (weasel)

The expanding skin was coming from my hip

ugh!

Moderators

Nancy-

We are so sorry for what you've been through! Hopefully your insurance will covers the procedure. It sounds like you've been through so much, we hope you have an easier of it from here on out. You've found a community of support here, we're here for you!

The Mods