How Much Does Breast Reconstruction Cost?

The two most common questions among breast cancer patients considering breast reconstruction are “how much does breast reconstruction cost?” and “will my insurance cover it?”

The good news is that even though plastic surgeons perform breast reconstruction, it is not considered cosmetic surgery. The bad news is that even though insurance covers breast reconstruction, there are still some costs that the patient will be responsible for. 

To ensure you’re fully prepared for the cost of breast reconstruction, here is a breakdown of factors to consider, including in-network vs. out-of-network coverage implications and estimated costs of breast reconstruction.

Is Breast Reconstruction Covered by Insurance?

Most breast reconstruction procedures are covered by insurance, including revisions, symmetry procedures, and even surgeries performed years after your mastectomy. This is partially attributed to the Women’s Health and Cancer Rights Act (WHCRA), which requires group health plans that cover mastectomies to also cover reconstruction-related procedures.

However, even though insurance companies are mandated to cover reconstruction, breast reconstruction insurance laws do vary by state. For this reason, it’s important to ensure your surgeon is in-network for your insurance plan. 

What Out-of-Pocket Costs for Breast Reconstruction Should You Expect?

Having insurance coverage certainly provides some financial relief, but there are usually still some out-of-pocket costs you should be aware of. Typically, your out-of-pocket costs can still vary depending on:

• Out-of-network vs. in-network benefits
• Travel and lodging expenses, especially if you’re coming from out of state
• Your insurance plan’s breast reconstruction deductible and co-insurance

Bottom line: While out-of-pocket expenses can differ, our goal at PRMA is to ensure advanced breast reconstruction is as accessible and stress-free as possible.

In-Network vs. Out-of-Network Surgeons: Why It Matters

When considering the costs associated with breast reconstruction surgery, it’s essential to understand the difference and financial implications between in-network and out-of-network surgeons.

Choosing an in-network surgeon means your insurance will cover a more significant portion of the costs, resulting in lower out-of-pocket expenses for you, like reduced breast reconstruction deductibles, co-pays, and co-insurance rates. 

On the other hand, seeing an out-of-network surgeon can lead to higher out-of-pocket costs, and in some cases, your insurance may cover very little or none of the procedure. Understanding this difference is key, because it directly affects what you’ll be financially responsible for—and can make the difference between a manageable expense and a significant financial burden. 

Are Preventive Mastectomy Reconstruction Surgeries Covered?

Reconstruction after a preventative (prophylactic) mastectomy is typically covered by insurance. Whether you carry a genetic mutation like BRCA or have a strong family history of breast cancer, many insurance plans will cover both the mastectomy and the reconstruction that follows. Under the Women’s Health and Cancer Rights Act, coverage isn’t limited to cancer-related mastectomies—reconstructive rights extend to preventative procedures as well.

At PRMA, we work closely with your insurance provider to confirm your benefits ahead of time and ensure you fully understand what’s covered. If you’re taking proactive steps to protect your health, you deserve support, not financial uncertainty.

Traveling for Breast Reconstruction: Is It Worth the Cost?

Traveling for breast reconstruction can feel like a big step—but for many women, it’s worth it. Choosing a specialized center like PRMA—known for advanced techniques, dual-surgeon precision, and sensation-restoring innovations—can mean better outcomes, fewer complications, and a reconstruction that truly feels like you. 

PRMA Offers Expert Breast Reconstruction With Insurance Support

At PRMA Plastic Surgery, our experienced breast reconstruction surgeons specialize in advanced reconstruction procedures, including DIEP Flap, GAP Flap, and Hidden Scar Mastectomy. We work with most major insurance providers and help patients nationwide navigate the coverage process with confidence. 

If you’re seeking natural results with trusted care, schedule a consultation with our team today.