Does Insurance Cover Breast Implants?

Breast augmentation surgery, which involves the placement of breast implants for cosmetic reasons, will cost an average of $4,516 in the United States in 2020.

The majority of women are responsible for paying this out of their own pockets. Breast augmentation surgery is frequently not covered by insurance. Breast implants will, however, be covered for women who have had mastectomies owing to breast cancer.

If you require additional surgery in the future, your health insurance may not pay it. Breast implants may effect your insurance rates in the future.

How do I get insurance to cover breast implants?

First and foremost, health insurance providers are interested in the original reason for your breast implants (as well as Medicare and Medicaid).

If your implants were placed after a mastectomy and your doctor thinks they should be removed, “The Women’s Health and Cancer Rights Act of 1998 requires your health insurance to fund your breast implant removal if it is “medically necessary” (WHCRA).

If you got breast implants for the purpose of enhancing your healthy breasts, certain health insurance companies will pay your explant surgery if they judge the services to be necessary “Medically required.”

How much do breast implants cost 2020?

So, what does it cost to get breast implants? As recently as 2020, the average cost of breast implant surgery will be between $6,000 and $12,000. While this price may appear to be a good investment, it’s worth noting that the cost of breast implants has remained quite constant over the last few decades. Breast implants are also often thought to be a long-term investment because of how long the results last.

A breast lift, for example, might cost anything from $9,000 to $16,000. The relative intricacy of a breast lift is one reason why it can be more expensive than breast implants. Breast lift surgery is often more expensive than breast implants because it requires more time and skill from the surgeon to remove tissue and lift the breasts into a higher position. The disadvantage of this higher price is that the results of a breast lift do not endure as long as those of breast implants.

What Determines Breast Implants Cost?

Naturally, the average price range for breast implants pertains mostly to the cost of the procedure. Varied types of implants have different price tags, which is typical. The size of the implant, in particular, may play a significant role in the final cost of breast implant surgery. Another aspect that may influence the price of breast implants is the operation procedure, such as whether the implant is placed under or on top of the pectoral muscle; the more involved the surgery, the higher the price.

How much do breast implants cost 2021?

The cost of breast implants is determined by the location, doctor, and implant type. The operation usually costs between $5,000 and $10,000. Breast augmentation is frequently not covered by health insurance because it is a cosmetic operation.

How much do just breast implants cost?

“How much do breast implants cost?” is one of the most often asked questions about breast augmentation.

While it’s impossible to determine exactly how much this treatment will cost for each individual at first sight, there are some rough figures accessible. A breast augmentation, for example, might cost anything from $6,000 to $12,000. But why is there such a wide price range?

The cost of breast augmentation varies depending on a number of factors. Learning about these aspects can help patients better prepare and plan for one of the most life-changing and confidence-boosting operations available, as well as everything that goes into deciding the cost so that you can make the best decision possible.

Will my insurance pay to have my breast implants removed?

Are you wondering if your health insurance will cover the cost of removing your breast implants? Although contracts and rules differ, in general, the insurance company will look at the original purpose for the implants.

  • If the implants were placed after a mastectomy and the doctor thinks they should be removed, “If the breast implant removal is deemed “medically essential,” health insurance is compelled to pay for it.
  • If the original purpose of the breast implants was to enhance the appearance of healthy breasts, some health insurance companies will fund explant surgery if the services are deemed necessary “Others, however, will not consider it “medically necessary.”

What if my insurance provider says “cosmetic surgery issues” aren’t covered?

Don’t let yourself down. Almost all health insurance coverage exclude “cosmetic surgery” and “cosmetic surgery consequences,” but don’t give up. Many insurance make exceptions for issues from breast implants if they are deemed “medically required” or “reconstructive surgery” in certain instances.

Varied health insurance companies have different definitions for this, and it also differs by state.

Even if the doctor believes that removing the breast implants is medically required, the health insurance policy could refuse to pay if the policy’s definition of medically necessary differs from the doctor’s.

Most of the most generous health insurance coverage for breast implant removal are based on one of the following conditions:

  • Baker III or Baker IV capsular contracture is caused by silicone or saline implants.
  • Breast implants that need to be removed due to infection or BIA-ALCL (Breast Implant-Associated Anaplastic Large Cell Lymphoma, an immune system disease).
  • Rupture: If the implants have ruptured, proof is required. Implant ruptures are best measured with MRIs, however ultrasounds or mammograms may also be used. Mammography, on the other hand, can cause existing breast implants to shatter or leak, and it is not particularly accurate at identifying rupture, so it is best to avoid it.
  • Breast implants are a “foreign body,” and most women’s bodies naturally respond by forming scar tissue around the implant inside the body to defend the body from this “foreign invader.” This is a natural occurrence. When the scar tissue around the implants tightens or hardens, it is referred to as capsular contracture. Breast implants made of saline or silicone can cause capsular contracture. It can make you feel a little uneasy or cause excruciating agony. The mildest form of capsular contracture is known as “Baker I” or “Baker II” (after Dr. Baker, who created the classifications), whereas the most severe is known as “Baker III” or “Baker IV.” Breasts that are Baker III or Baker IV are hard and/or painful. Baker III and/or Baker IV level capsular contracture is usually only considered a medically required reason for removal by insurance carriers.
  • Chronic Breast Pain: Capsular contracture pain is frequently stated as grounds for insurance coverage of breast excision. Furthermore, if the implants are causing severe discomfort due to nerve damage or the weight of the implants, the insurance company may be able to cover the cost of removal.

Unfortunately, most insurance companies do not consider any autoimmune diseases/symptoms or anxiety related to the implants as indication that removing the implants is medically essential. Many women with those symptoms, however, also have other issues like leaky silicone implants or capsular contracture. Concentrate on the symptoms that the insurance company is interested in, rather than the ones that aren’t covered.

When the objective of the surgery is to remedy a medical condition, some insurance companies will consider breast implant removal “reconstructive surgery” rather than “cosmetic surgery” and thus medically required. This usually indicates Baker grade III or IV capsular contracture, as well as restricted movement that makes it difficult to perform simple actions like reaching over the head. If there are silicone lumps in the breast area that interfere with the identification of breast cancer, breast implant removal may be considered restorative.

When it’s time to approach the insurance company for coverage, Fox Valley Plastic Surgery writes the insurance company a letter explaining why breast implant removal is medically required. The emphasis is on complications that are more likely to be reimbursed by insurance (such as implant rupture or Baker III or IV capsular contracture), rather than symptoms that the insurance company will not pay (such as autoimmune symptoms).

How long do breast implants last?

Today’s implants are designed to last more than a decade on average, with the risk of rupture increasing by 1% each year. As a result, the older your implants are, the more likely they are to rupture or cause other issues.

Breast implants can last up to 20 years in most situations. Every patient is unique, and the longevity of your implants will be determined by your body and how you care for them.

Is breast lift cheaper than implants?

You’re not alone if you’re uncomfortable with the size, shape, or position of your breasts. According to the American Society of Plastic Surgeons, breast augmentation, popularly known as a boob job, and breast lift surgery remain the most popular plastic surgery operations. 1 However, they’re two distinct operations that aim to achieve different aesthetic aims. To help you choose the best breast surgery for you, here’s what you need to know about breast lifts vs. breast augmentation.

Differences between a breast lift vs. boob job

Depending on your cosmetic goals and personal preferences, each form of breast surgery offers its own set of benefits. Both breast lifts and boob jobs are surgical treatments that require incisions; however, the scars are usually minor and disappear to a thin line over time.

What is a breast lift?

The goal of a breast lift is to improve the position of the breasts. Due to weight reduction, pregnancy, skin elasticity, and hormonal changes, the surgery might enhance the appearance of droopy, sagging breasts. If you’re content with the size of your breasts but not the position, a breast lift, also known as a mastopexy, is a great option. A breast lift involves the removal of extra skin, tightening of surrounding tissue, and repositioning of the nipple to give the breasts a more young, sculpted appearance. Breasts may appear bigger and shapelier as a consequence of a lift since some skin is removed. A breast lift produces rapid and long-lasting effects.

What is breast augmentation?

Breast augmentation surgery, sometimes known as a boob job, entails utilizing saline or silicone implants to increase and enhance breast size and shape. Other things to consider include implant form, implant type, and placement on your chest, in addition to desired breast size. Breast augmentation results can take a few weeks to appear and can endure for years. Breast implants may need to be replaced over time as a result of variables such as aging and weight fluctuations.

How much is a boob job or breast lift?

A breast lift costs $4,8162 on average, while breast augmentation, sometimes known as a boob job, costs $3,824.3. Keep in mind that prices vary by region, and these averages don’t cover charges for general anesthesia, the surgical facility, or other related costs such as post-surgery clothes or prescription drugs. Consult your plastic surgeon’s office for an estimate of your costs.

How to choose between a breast lift and a boob job?

While your breast size and position may influence which breast surgery is best for you, many people choose to have both operations done at the same time. Because a person’s breasts aren’t always symmetrical, it’s not uncommon for each breast to undergo a somewhat different surgery. A consultation with an expert, board-certified plastic surgeon can help you decide whether a breast lift, breast augmentation, or both procedures are right for you.

How painful is breast augmentation recovery?

As you heal from the treatment, your soreness will progressively fade in the weeks after your surgery. With the exception of minor soreness, many women have little to no pain within 2 to 3 weeks. The majority of your soreness should be gone by the time you reach one month after surgery.

What is the divorce rate after breast implants?

Cook et al7 reported a divorce rate of 28.8% in breast augmentation patients, compared to 18.1 percent in comparison participants, as previously mentioned.

Why you should never get breast implants?

The Food and Drug Administration (FDA) in the United States has discovered a link between breast implants and the development of anaplastic large cell lymphoma (ALCL), a rare immune system cancer. Breast implant-associated anaplastic large cell lymphoma is the name of the condition (BIA-ALCL).