09 May

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.

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13 Comment

  1. Amber

    Seeking advice for reconstruction of my breast. Left breast is a D right breast is a B, both have no density. I cannot find a bra to fit me. I look lopsided and my left shoulder goes numb at times

    1. PRMA Plastic Surgery

      Good morning Amber! To properly recommend options for breast reconstruction, you should be evaluated by a board certified plastic surgeon. You are more than welcome to give us a call at 210-692-1181 to schedule, or you can fill out our virtual consultation form at https://prma-enhance.com/schedule-your-consultation/

  2. Amanda

    Hi, I would just like a rough idea how much breast reconstruction costs. I just want my breast lifted and put back where they were in my 20s :o) Im 51 and single and very concious of them as they are very empty and droopy

    1. PRMA Plastic Surgery

      Hi Amanda! It is hard to give a cost estimate on this type of procedure because it can vary a great deal between patients. We would be more than happy to get you scheduled for a consultation to come see us, so we can give you a better recommendation! You can also read more about our breast procedures here: https://prma-enhance.com/cosmetic-surgery/breast-augmentation/. If you would like to schedule a consultation you can give us a call toll free at 800-692-5565

  3. Yojana Bindu choudhary

    I want to know about the cost of diep flap reconstruction surgery of breast. I’m Indian but my keen desire that come to prma plastic surgery center and reconstruct my breast so plz give me advice and help me. Thanks.

  4. lovie g Fitzpatrick

    I’ve had to different capsule of my breath where they have hardened. Now I have taken the implants out for 8 months and I have so much shrinkage on one and scar tissue on another that after seeing 3 plastic surgeon all said I need a reconstructive surgeon. Do you think I could be covered for this through my ins even thou it was caused by cosmetic surgery? Breast implants

    1. PRMA Plastic Surgery

      So sorry to hear you are going through all of this. Sadly, in most circumstances insurance will not cover the cost of additional surgery needed after implant complications for implants that were placed cosmetically.

  5. May

    Please I would like to have an estimate for unilateral DIEP delayed breast reconstruction surgery.

    I am in Canada and my insurance will not pay if done outside my province and my country.

    I am aware that each surgery is different but in general how much it cost approximately.

    Thank you in advance,

    1. PRMA Plastic Surgery

      Thanks for reaching out May! You are correct that every surgery is different and as such it is difficult to give a proper cost estimate for a patient paying out of pocket. We would need to evaluate your needs and develop a personalized surgery plan before providing a cost estimate. We would be more than happy to schedule you a virtual consultation so you can meet with one of our board-certified plastic surgeons from the comfort of your home. You can fill out our virtual consultation form at https://prma-enhance.com/schedule-a-consultation/

  6. Veronica

    I had double mastectomy and nipple removal and I’m looking what’s the cost for Diep flap and if it would be recommended.

    I had cancer in my left breast. Lately I’ve started getting small fatty lumps and my left implant flip inside my breast. My breast are very uneven and I have consults with my doctors whom recommend me to have more fat transfer done

    1. PRMA Plastic Surgery

      Thanks for reaching out Veronica! We would be more than happy to evaluate your needs and provide you with our surgical recommendations along with a cost estimate based on your insurance patient responsibility requirements. We welcome you to fill out our virtual consultation for at https://prma-enhance.com/schedule-a-consultation/

  7. Carolyn Evans

    Hello I am writing today for my Sweet friend. She didn’t opt for a Masctomy when she was diognosed with her breast cancer. Then she found out that is she had done a Masctomy then her insurance would have paid or helped. It’s so sad you think you are doing the right thing because I cannot imagine how scary it would be to choose to have a Masctomy when the surgeon says otherwise. She is disfigured from all the surgery that was done. She told me a couple of weeks ago that she is Grateful to have survived the cancer and Radiation but she is Depressed because she is disfigured now. Her husband is cheating on her and this only added to her worthlessness… I just wanted to know if there is somewhere she can get help with the surgery costs??? Any information would be helpful… Thank You!!!

    CAROLYN EVANS