Preventative BMX w/Reconstruction - Insurance?

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Tmh0921
Tmh0921 Member Posts: 714
edited August 2018 in Breast Reconstruction

A little background on me - I had my first biopsy for fibroadenomas at 22 years old. Had several between ages 22 and 27 (both breasts). At 27 years old, was DX with stage 1B IDC in my left breast. Had several more biopsies for fibroadenomas and cysts (both breasts) between ages 27 and 44. At age 44, in 2016, was DX with ADH in left breast (same breast as BC), and just today was DX with ALH in the left breast (same breast as BC). I also am currently awaiting pathology results for linear pleomorphic calcifications in my right breast.

To say I'm over all of these constant biopsies, waiting, and worrying is a vast understatement. Enough is enough, especially with ALH entertaining the mix.

I have an appt with my surgeon on Monday to schedule an excisional biopsy for the ALH. But I'm also going to talk to him about preventative bilateral mastectomy with DIEP reconstruction (and get the referrals underway)

My question is this - without a current active cancer, will insurance pay for the mastectomy and reconstruction?

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  • Tmh0921
    Tmh0921 Member Posts: 714
    edited August 2018

    Heard back from the insurance company this evening, and due to my history and risk, I AM covered for both prophylactic double mastectomy AND reconstruction. So now I just need to meet with my surgeon and oncologist to get the ball rolling so to speak.

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