http://www.plasticsurgerypractice.com/issues/articles/2008-05_05.asp
INPRACTICE
Is It Covered?
by Patricia McGuire, MD
It is time to get educated about insurance reimbursements for breast procedures
I think that it is necessary for an individual insurance company to cover breast augmentation following a mastectomy or for any other medical reason for breast augmentation. For these purposes I
see it in the same light as any other prosthetic. One would not deny someone who needed a prosthetic hand due to amputation from cancer or otherwise, so why should a breast be any different. In this article they do not focus on breast reduction at all. In my opinion that form of breast reconstruction should also be covered when done for medical reasons i.e. back problems. On the other hand, I do agree with some insurance companies that "[t]he insurance company's stand is that if the patient chooses to pay for aesthetic breast augmentation, all costs related to the surgery are the patient's responsibility." If the procedure is purely cosmetic the patient is fully aware of the risk and future costs, and it is completely elective. If cosmetic breast reconstruction coverage begins where will the line on coverage be drawn? That being said, if the patient has a defective implant, leak or an unsuccessful surgery I believe the cost should be place on either the surgeon or the supplier of the
implants to ensure quality.
INPRACTICE
Is It Covered?
by Patricia McGuire, MD
It is time to get educated about insurance reimbursements for breast procedures
I think that it is necessary for an individual insurance company to cover breast augmentation following a mastectomy or for any other medical reason for breast augmentation. For these purposes I
see it in the same light as any other prosthetic. One would not deny someone who needed a prosthetic hand due to amputation from cancer or otherwise, so why should a breast be any different. In this article they do not focus on breast reduction at all. In my opinion that form of breast reconstruction should also be covered when done for medical reasons i.e. back problems. On the other hand, I do agree with some insurance companies that "[t]he insurance company's stand is that if the patient chooses to pay for aesthetic breast augmentation, all costs related to the surgery are the patient's responsibility." If the procedure is purely cosmetic the patient is fully aware of the risk and future costs, and it is completely elective. If cosmetic breast reconstruction coverage begins where will the line on coverage be drawn? That being said, if the patient has a defective implant, leak or an unsuccessful surgery I believe the cost should be place on either the surgeon or the supplier of the
implants to ensure quality.
This is very helpful, I enjoyed reading it. I'm sure it will be helpful to women who are considering the procedure. Financial status will always be an issue when it comes to any cosmetic surgery procedure. This is also an important thing to check aside from breast augmentation prices .
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