Does Insurance Cover Breast Augmentation?

Patients seek breast augmentation procedures for many reasons. While procedures and surgery options are flexible, insurance coverage is less so. It can be frustrating trying to communicate with your doctor, your surgeon, and your insurance company. You will want to know does insurance cover breast augmentation? You will want to know In some cases, insurance companies will not provide any coverage for elective procedures at all.

Our Houston plastic surgery experts can offer some wisdom that may help you figure out whether you have a chance of getting some – or all – of your breast augmentation surgery covered.

Determining Your Reasons for Surgery

One of the first questions your doctors and insurance providers should ask you is why you are seeking breast augmentation surgery. Depending on your reasons, you may get some or all of your breast augmentation covered by insurance.

As an example, someone who has had to have a mastectomy because of breast cancer has a better chance of having an augmentation surgery covered than someone who is getting a breast augmentation for purely cosmetic reasons.

At the office of Dr. Cain Linville, we believe all reasons for wanting cosmetic surgery are justified. However, it is a little more difficult to convince some insurance groups to see things the same way. While breast augmentations for medical reasons are always covered, cosmetic augmentations are only covered under rare exceptions.

Knowing Your Costs

It is important that you check with your insurance company before assuming whether a procedure will or won’t be covered. If your insurance plan refuses to cover cosmetic augmentations, you should start calculating your costs so you can plan accordingly. As you continue to work with your insurance policy to gain some coverage, start calculating the below costs.

Diagnostics and Testing

Sometimes a single consultation isn’t enough. You may need to visit a testing site to run diagnostics or to have a physical examination. You may need an MRI, for example, especially after the surgery is complete. That way, doctors can keep track of your progress and ensure the implants are still working as intended.

An MRI test can be upwards of $2,000 without insurance. So that is something you will certainly have to factor into your surgery costs.

Follow-up Surgeries

You may require additional surgeries after your initial breast augmentation. Some patients may have an allergic reaction to the implant material. Or perhaps the implants themselves need a positional readjustment. Implants are a medical device like any other, and sometimes need some correcting or even replacement.

Some medical facilities will offer follow-up surgeries at no cost. But it is important to discuss this in detail with your surgeon and with your insurance company. This way, you know what to expect financially.

Additional Costs

At the scheduled time of your surgery, you may have to review additional costs. This means not only are you paying for the surgery, but you are also paying for:

  • Anesthesia
  • Hospitalization
  • Prescribed medicines
  • Other services

These costs need to play a huge part when you are calculating your expenses for the surgery.

Your insurance company may cover some of these costs, excluding the surgery itself. It is a good idea to stay in communication with your provider before making any big decisions.

Stay On Top of Your Surgery Needs!

Our experts at the office of Dr. Cain Linville are happy to work with you to find the best financial solution for you. We want to make your breast augmentation dreams a reality, and there are different coverages and payment plans available to help make that happen. Insurance can cover breast augmentation, but only in specific cases. If you are interested in learning more about your breast augmentation options, you can schedule a consultation with us at any time. Contact us online or give us a call at (713) 300-2567 to become a new patient today.