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Breast augmentation insurance coverage

Knwowing your breast augmentation insurance coverage is very important for ... financial reasons. Breast augmentation surgery and treatment of possible complications may not be covered by your health insurance policy. Typically, insurance companies will not cover breast enhancement and any reoperations and additional doctor visits following the surgery. However, most insurance policies cover the first breast reconstruction operation. Reoperation procedures and additional doctor visits following reconstruction also may not be covered, depending on the specifics of your insurance policy.

Aside from insurance coverage specific to your breast implants surgery, you need to find out about how breast enlargement surgery will affect your health insurance, as a whole. For some women, insurance companies may increase premiums, drop coverage, or deny future coverage following breast enlargement surgery or following complications from the breast enlargement or surgery. Policies on coverage may also change from year to year.

Before your breast augmentation surgery, be sure to get, in writing, answers from your health insurance company to the following questions, at a minimum:

  • Will my policy cover the costs of the breast enhancement surgery, the implants, the anesthesia, and other related hospital costs? If so, to what extent?
  • Will it cover removal and replacement of the implants if this becomes necessary? If so, to what extent?
  • Will it cover the cost of detecting or treating a complication resulting from either the implant or the surgery? If so, to what extent?
  • Will there be an increase in my health insurance premium? If so, to what extent?
  • Will future coverage be impacted? If so, to what extent?


Here is an example of what your insurance policy could say:

Breast augmentation Expenses related to breast augmentation (such as implants or injections) are not reimbursable because the procedure is cosmetic in nature. However, medical costs related to the removal of breast implants that are defective or are causing a medical problem are reimbursable.



Breast reduction Medical expenses related to breast reduction surgery are reimbursable only if a physician substantiates that the procedure is medically required and not for cosmetic purposes (that is, to prevent or treat an illness or disease).

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