Insurance coverage for revisions?

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ready2bedone
ready2bedone Member Posts: 95
edited September 2017 in Breast Reconstruction

Dumb question maybe but if you have any problems with your reconstruction such as the breasts not being the same size or one sags more than the other (assuming both are done) does your insurance pay for whatever additional surgeries might be needed? Not that I want to have any additional surgeries - really hoping to do as few as possible. But just wondering if it is an option later if I am not happy with results.

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  • Mucki1991
    Mucki1991 Member Posts: 294
    edited August 2017

    I believe it does as it covers revisions and touch ups. I know mine will as I will need fat graphing etc.

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  • NotVeryBrave
    NotVeryBrave Member Posts: 1,287
    edited August 2017

    Many insurers have a "statement" - some online - that detail what and how many are covered. You can probably check through your insurance website or just look it up online - something like "Aetna breast reconstruction" or the like.


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  • TarheelMichelle
    TarheelMichelle Member Posts: 871
    edited August 2017

    Yes, usually there are no limits. Unfortunately, several surgeries may be needed for some women who have problems. But it's a good thing to know, in case your results are just a "little" off, that your insurance will cover it.

    My health insurance statement of coverage contained wording about breast surgery to repair, replace and restore, with no mention of time limits. I didn't have fat grafting until 5 years after my lumpectomy. Insurance covered it and will cover it again if needed.

    As an aside to others who may be reading this, insurance coverage may also be available for bras and prosthesis. A couple of years after my lumpectomy, and before my fat grafting, I lost weight, and the size difference between my two breasts became prominent. Insurance covered a partial prosthesis for one breast, which I used until I could schedule fat grafting. Insurance also covered camisole-type bras to hold the prosthesis, and the camisoles were pretty enough to wear by themselves.

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  • marketingmama
    marketingmama Member Posts: 161
    edited August 2017

    Has anyone changed insurance providers midway through reconstruction? I just did (from United to Cigna) and slightly concerned.

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  • PNWBCHgirl
    PNWBCHgirl Member Posts: 115
    edited August 2017

    yes I did and everything went fine. The new insurance always questions everything but it always gets ok'd

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  • janlee15
    janlee15 Member Posts: 4
    edited September 2017

    Under the 1998 Womens Health and Cancer Rights Act, any insurance company that covers mastectomies must by law also cover reconstruction, including all stages of reconstruction of the breast on which the mastectomy was performed, surgery and reconstruction of the other breast to produce a symmetrical appearance, prostheses and treatment of physical complications of the mastectomy. This applies even if you change insurance companies. If the new insurance company covers mastectomies ( and most do) then they must cover all the other things mentioned above. It also covers second opinions. This law is administered by the Department of Health and Human Services, so if you have any problems you should probably contact them with your complaint. Hope this helps.

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