Breast Reconstruction is Covered by Insurance

By: Brandy (Korman) Haslam

Blogs
February 07, 2014

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. 

Learn More About Breast Reconstruction Being Coverer by Insurance

6 Comments

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  • PRMA

    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.

    Reply
  • PRMA

    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 .(JavaScript must be enabled to view this email address). I’d love to help! -Brandy

    Reply
  • PRMA

    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?

    Reply
  • PRMA

    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 ?

    Reply
  • PRMA

    Hey Sharon! 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.

    Reply
  • PRMA

    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!

    Reply
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