ShareIn This Article
Is breast reconstruction covered by insurance?
When diagnosed with breast cancer, the last thing you want to worry about is whether or not your mastectomy and breast reconstruction will be covered by insurance.
Prior to 1998, many patients did have to pay for the cost of surgery out of pocket – particularly if they wanted breast reconstruction to fix the mastectomy defect.
Fortunately with the passing of the Women’s Health and Cancer Rights Act (WHCRA) by Congress in ’98, breast reconstruction is now mandated by Federal Law to be covered by insurance if the cost of mastectomy is covered.
Watch the video for more information on insurance coverage for breast reconstruction from Dr. Oscar Ochoa.
Fortunately with the passing of the Women’s Health and Cancer Rights Act (WHCRA) by Congress in ’98, breast reconstruction is now mandated by Federal Law to be covered by insurance if the cost of mastectomy is covered.
Leave Comment
-
-
Hi Polly, radiation does not prohibit you from having breast reconstruction regardless of how long ago you had it. If you would like more information on breast reconstruction, please contact me at 800.692.5565 or email me at patientadvocate@prmaplasticsurgery.com. I’d love to help! -Brandy
July 20,2020
-
-
I had a parcel mastectomy in 2007. I was told at the time I could only have reconstruction Surgery if I had a double masectomy. Is this true, or am I eligable?
July 20,2020
-
This is a great question! After a lumpectomy (or partial mastectomy), you are eligible for reconstruction. There is no requirement of a double mastectomy for insurance to cover reconstruction.
July 20,2020
-
-
in 2009 I had a single mastectomy (right). This year I went to Dallas to have reconstruction surgery but I am not happy with the results at all. I am on Medicare with a supplemental plan. I think that doctor in Dallas just did the minimum. Can I try again to have it done right? This time I would have a mastectomy on the left side and have everything match. Can you help me ?
July 20,2020
-
Hey Linda! It really depends on your specific case. It is possible to revise a previous reconstructive surgery, but it could be considered cosmetic by your insurance. You would need to be evaluated by one of our surgeons to see what could be done to correct your concerns. Please feel free to give us a call to schedule a consultation at 800-692-5565. Thanks!
July 20,2020
-
-
I had breast cancer surgery in 2006 in2009 had tram flap surgery and was then it would require another possible 6 or more surgeries. I stopped at that point. I was wondering if it’s possible to finish out the recon. Now without having. To go through that many more. The breast out pretty much there now. It’s just nipple and a tiny bit of breast shaping that needs to be done in both left and right sides. I’m 60 now but want to look a little bit better please.
September 29,2020
-
Great question Donna! To best answer your questions we would need to evaluate your individual needs. We would be more than happy to chat with you more via our virtual consultation process. We welcome you to fill out our virtual consultation form at https://prma-enhance.com/schedule-a-consultation/
September 29,2020
-
Sign Up for Our Monthly Newsletter
Continue Reading
DIEP Flap Breast Reconstruction at PRMA: Priscilla’s Story
DIEP Flap Breast Reconstruction at PRMA: Priscilla’s Story January 13, 2022 Share on Facebook Twitter Linkedin The DIEP flap is the most advanced breast reconstruction technique currently available today. At PRMA, it is also the recommended method. The procedure uses the patient’s own abdominal skin and fat. After a mastectomy, the tissue is used to recreate a […]
What Breast Cancer Patients Should Know About FDA’s New Breast Implant Safety Rules
What Breast Cancer Patients Should Know About FDA’s New Breast Implant Safety Rules January 11, 2022 Share on Facebook Twitter Linkedin There are now new breast implant safety requirements from the FDA. Beginning in October 2021, all implant boxes must now come with a warning label informing patients of the potential risk of Breast Implant-Associated […]
Should I Get Breast Reconstruction Surgery?
Should I Get Breast Reconstruction Surgery? December 03, 2021 Share on Facebook Twitter Linkedin After breast cancer treatment, Breast reconstruction helps women become physically and emotionally whole again. Breast Reconstruction restores something that nature once provided but cancer has taken away. Unfortunately, many patients with breast cancer who have had a mastectomy or lumpectomy are […]
Guest Post: Improving Women’s Sex Life After Breast Cancer
Guest Post: Improving Women’s Sex Life After Breast Cancer November 22, 2021 Share on Facebook Twitter Linkedin Most women with breast cancer notice negative changes in their sex lives. By some estimates, over 80% of women treated for breast cancer end up with sexual problems. Unfortunately, at least half of women do not recall discussing […]
What NOT To Say To Someone Who’s Had A Mastectomy
What NOT To Say To Someone Who’s Had A Mastectomy November 11, 2021 Share on Facebook Twitter Linkedin If you have a loved one who is preparing for or recovering from a mastectomy, there are a few things you should avoid saying – and a few things you should say instead. Don’t say “You’re too […]
Emotional Wellness and Breast Cancer
Emotional Wellness and Breast Cancer November 02, 2021 Share on Facebook Twitter Linkedin When you’re diagnosed with breast cancer, it’s normal to experience a range of emotions at different points during your treatment and recovery. You may be surprised and overwhelmed at first and then become terrified or angry. It’s common to have both good […]
What Everyone Should Know About Breast Cancer
What Everyone Should Know About Breast Cancer October 19, 2021 Share on Facebook Twitter Linkedin Breast cancer affects many women in the United States and around the world. For every 8 women in the United States, 1 will be diagnosed with breast cancer during her lifetime. Women, and men, also have an increased risk of […]
What October Means To Me
What October Means To Me October 07, 2021 Share on Facebook Twitter Linkedin Breast Cancer Awareness Month is celebrated around the country every October. The occasion brings attention to breast cancer, but many people affected have mixed feelings about it. There’s no doubt this awareness campaign means different things to different people. For some, it’s […]
Top 3 Reasons Patients Delay Breast Reconstruction
Top 3 Reasons Patients Delay Breast Reconstruction September 27, 2021 Share on Facebook Twitter Linkedin When considering breast reconstruction after breast cancer surgery, patients have two timing options. Immediate or delayed. Immediate breast reconstruction is performed at the same time as the mastectomy. There are many benefits to immediate reconstruction. These include shorter recovery and […]
I had lumpectomy and 33 radiation treatments about 19 years ago on my right breast. One week ago I had modified radical mastectomy on my right breast due to a malignant tumor. Is it possible for me to have breast reconstruction even though I had radiation years ago on that breast. I am 67 years old but I don’t have any significant health issues such as high blood pressure or diabetes. Considering my age aside from the breast cancer I am in pretty good health.
Polly
July 20,2020