Breast lifts are not covered by all insurance providers, and even those that do aren’t covered in all circumstances. The medical need of the surgery is usually the deciding factor. If the procedure is deemed medically essential, the insurance company may pay for it. This is especially true for women who require breast reduction surgery because their breasts are giving them other health problems. In some cases, a breast lift is also required to assure the effectiveness of the breast reduction surgery, and the insurance company may pay both procedures.
It doesn’t always matter whether you or your doctor think the operation is medically required to persuade an insurance company. It’s worth taking a few extra measures to check if you can have a breast surgery preauthorized to see if your breast lift is covered by insurance.
- Examine your insurance benefits paperwork to check if certain treatments, or breast reductions or lifts in particular, are mentioned. Keep in mind that these policies are often written in legalese, which can be confusing, so calling the insurance company to ask for clarification is usually a good idea.
- If you think your insurance company would cover your breast lift, have your doctor produce a note of medical necessity. Provider offices will typically understand what is required in such a letter and may have previously worked with the insurance company. If necessary, work with your provider to make this process easier.
- Find out what documentation your insurance company need for preauthorization by speaking with a caseworker or pre-authorization representative. This is your insurance company’s formal (often written) acknowledgement that it approves services to be done and that it will cover the treatment as long as all preauthorization standards are met.
- Speak with your provider to ensure that the office understands what evidence is required to make good on the claim and that they are prepared to charge it correctly.
- Check to see if the surgeon is part of your insurance plan’s network. Going out of network can result in a loss of coverage or a significant increase in the amount you’ll have to pay.
- Make sure you understand your copay and deductible amounts. Even if the operation is covered, you may still be responsible for a percentage of the cost.
Whether or not your breast lift is covered by insurance, inquire about financial arrangements with your provider’s clinic. You might be able to set up a payment plan, and if you don’t have insurance, see if there are any reductions for paying in full at the time of service.
How do you get a breast lift covered by insurance?
In general, each insurance provider selects which procedures are covered and which are not. The most important consideration for insurance companies is whether the operation is reconstructive or cosmetic. These are defined by the American Medical Association (AMA) as follows:
- Procedures to address damage, developmental abnormalities, illness, or disease are referred to as reconstructive surgery. Reconstructive surgeries aim to improve a patient’s function or restore their look.
- Cosmetic surgery refers to surgeries that aim to improve a patient’s look or self-esteem by improving the aesthetic appearance of the face or body.
However, depending on the method and situation, several insurance companies may interpret the aforementioned concepts differently. Because of these differences, it’s critical to speak with your insurance provider about how your treatment will be classified. While plastic surgeons (and their billing representatives) can advise you on insurance coverage options, it’s always preferable to go straight to the source.
Breast lift surgery is often considered cosmetic and is unlikely to be reimbursed by medical insurance. Medical need would have to be established for such a procedure to be permitted. Back/neck/shoulder difficulties can sometimes be traced back to excessively enlarged breasts, and a case of medical need for breast reduction surgery has been successfully made. However, if you are simply losing the war with time and gravity, you should not expect your health insurance to pay a breast lift.
How do you pay for a breast lift?
The cost of augmentation mammoplasty will vary depending on whether it is a cosmetic or a medical treatment.
Your insurance should cover breast implants if you have had a mastectomy due to breast cancer. Other medical issues, such as asymmetry, are frequently covered as well. However, if you’re having the treatment for cosmetic reasons, you’ll almost certainly have to pay for it yourself.
Credit card
Check to discover if your credit card’s credit limit will pay the entire procedure or only a portion of it. Make sure the card you’re using has a low interest rate as well.
If you’re considering getting a new credit card to pay the surgery, seek for one that offers a 0% introductory offer. The chance of receiving cash back or points on your purchase is an extra benefit of paying with a credit card. To see what you’ll get back using your card, learn how your issuer classifies medical treatments. Make sure you have a repayment plan in place to preserve your credit score and any debts in good standing.
Personal loan
Taking out a personal loan to pay for your breast augmentation is another possibility. A personal loan is an unsecured loan for a certain sum that is intended to assist in the payment of a significant purchase. The interest rate on your loan is mostly determined by your credit score and annual income. If you have decent to exceptional credit, personal loan rates might be as low as 5.95 percent.
Health insurance
Breast implants that are part of a breast reconstruction are usually covered by most health insurance plans. The Women’s Health and Cancer Rights Act covers breast implants following a mastectomy for breast cancer. This law requires insurers who provide mastectomy benefits to cover the reconstruction of the breasts removed during surgery, as well as the implants themselves.
Poland syndrome is another medical condition that is usually covered by most insurance plans. The operations in this situation are classified as breast reconstruction rather than breast augmentation. Breast augmentation is generally not covered by health insurance.
Health savings account
A health savings account, often known as an HSA, is a pre-tax account that is particularly intended for medical expenses. These accounts are available in conjunction with a low-cost, high-deductible insurance plan. When breast reconstruction surgery is required as part of breast cancer therapy, it is covered by an HSA. An HSA cannot be used for aesthetic operations that are not medically essential.
Patient financing plan
Most doctors are willing to work with patients to come up with a payment plan for their mammoplasty augmentation.
CreditCare is one of the most often used financing options. Over 200,000 healthcare providers in the United States accept CreditCare, a healthcare credit card. To see if your surgeon accepts CreditCare, look it up in the online database. The average annual percentage rate (APR) for this service is roughly 26.99 percent, though charges vary by account.
What is medically necessary breast surgery?
What does it mean when someone says “breast surgery (medically necessary)”? Hospital therapy for breast problems and associated lymph nodes, as well as reconstruction and/or reduction following breast surgery or a prophylactic mastectomy.
How much did you pay for a breast lift?
The most common types of lifts chosen by most ladies are the following. Each one is tailored to a specific breast shape. These are the five types:
- Crescent lift A plastic surgeon makes a crescent-shaped incision over the top edge of the areola during this surgery. The surgery’s goal is to improve the nipple’s location in relation to the breast.
- Peri-areolar (donut) lift A plastic surgeon makes a circular incision around the areola when doing a donut breast lift. This form of breast lift surgery is best for ladies who have tiny or medium-sized breasts that are drooping or sagging.
- Vertical (lollipop) lift – This type of breast lift surgery comprises two incisions: one around the areola and one extending vertically from the bottom of the areola to the breast crease. This surgery is ideal for women who desire to reshape their bodies while also correcting sagging.
- Anchor lift: A plastic surgeon makes three incisions: one around the areola, one vertically from the bottom of the areola to the breast crease, and one horizontally along the breast crease. This procedure is appropriate for ladies who have substantial sagging in their breasts.
- A plastic surgeon makes only one incision while conducting the Bellesoma method: around the areola and in the breast crease. There are no vertical scars, and other scarring is minimal because the scars disappear over time and blend in with the skin.
The average cost of these breast lifts in 2018 was $4,816 according to the American Society of Plastic Surgeons. This price excludes facility fees, breast implant expenses, and anesthesia charges, and is dependent on a number of factors, including:
What is a good age to get a breast lift?
Breast augmentation was most popular among young women between the ages of 19 and 34, according to the American Society for Aesthetic Plastic Surgery, who accounted for over half of all women who received breast augmentation in 2015. Women between the ages of 35 and 50 accounted for 38.7% of the total. Women between the ages of 51 and 64 accounted for over 11% of the total. The remaining 2% was distributed evenly between women aged 18 to 65 and those aged 65 and up.
Health (Not Age) Is the Most Important Factor
As long as a woman is in good health, she can benefit greatly from breast augmentation surgery. You must meet the following criteria to be a candidate for breast augmentation at our St. Louis practice:
There is no upper age restriction for breast augmentation (or any other cosmetic operation) as long as you are healthy and can support the alterations to your body.
What Women Want from Their Breast Augmentation Changes Over Time
While all women want to look better, what they seek from their breast augmentation changes as they get older. Women in their 40s and beyond aim to lift and restore the size, shape, and position of their breasts, whereas women in their 20s and 30s desire to improve the size, fullness, and projection of their breasts. Breast augmentation is frequently combined with a breast lift in women over 40. A breast lift with augmentation allows your surgeon to completely revitalize your breasts by lifting and supporting weakening breast tissue.
At Renaissance Plastic Surgery, we’ve had remarkable success with breast augmentation for women of all ages! The optimal age for breast augmentation is highly individual, and whether or not you are a candidate will be addressed and assessed during your appointment at Renaissance Plastic Surgery in St. Peters.
How can I fix my sagging breasts naturally?
Here are some options for you to consider.
- Keep a healthy weight in check. You don’t have to lose weight, and you don’t have to gain weight.
How many years does a breast lift last?
When it comes to how long your breast lift results will last, there is no simple answer. Some patients’ breast lift results last for more than 15 years, while others may need minor cosmetic changes sooner. Breast lift outcomes often last 10 to 15 years.
Many of our Waukesha patients seek out Dr. McCall’s expertise because she has a reputation for achieving long-term outcomes with conservative procedures.
Is a breast lift cheaper than augmentation?
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.
When does Medicare cover breast lift?
- MBS codes are subject to change at any time. In addition, the coverage of private health insurance policies changes on a regular basis.
- Always check Medicare and your insurance company for the most up-to-date information.
- Some post-partum surgery, such as Breast Lift operations for moderately to severely ptotic nipples, is corrective in nature and may be covered by Medicare. This, however, is subject to a set of severe restrictions.
- Your GP and specialist may be able to determine whether your needs fulfill the tight Medicare rebate criteria for post-pregnancy Breast Lift Surgery.
Download The Tummy Tuck or Breast Lift Surgery Guide or phone 1300 264 811 today and ask for a no-obligation consultation.
This blog includes an explanation of the Medicare system as well as operations including plastic or cosmetic surgery. It is not exhaustive, and other revisions may be necessary.