Will Insurance Cover the Cost of Breast Reconstruction?


Are you considering breast reconstruction surgery, but worry about the cost? You may be surprised to learn that most insurance companies that cover mastectomies also cover reconstruction. Come in and talk with us about your specific situation, but know that much of the time insurance will cover all or part of the cost of your reconstruction surgery. Take your body back after breast removal with breast reconstruction surgery. It is important to note that here at the Plastic Surgery Center of Nashville, we are no longer “in network” for any insurance plans.  We also no longer participate in Medicare.  Some insurance plans may have out of network benefits that cover all or part of the cost of your surgeon’s fee, the coverage for anesthesia and the facility should remain the same.  We can also refer to one of our colleagues here in Nashville that is a provider on your insurance plan if that is your preference.

Insurance and Breast Reconstruction: What Are My Rights?

If you have insurance coverage, it may cover the cost of your breast reconstruction surgery. The Women’s Health and Cancer Rights Act of 1998 entitles many women on group and other health insurance plans to receive coverage for breast reconstruction or prosthesis. In addition many states have laws that require insurance companies not covered by the Women’s Health and Cancer Rights Act to cover reconstruction surgery.

Every situation is different, but we can help to understand what coverage and payment options may be available to you at a consultation appointment. Call today to schedule yours. With insurance coverage and payment options, breast reconstruction might be more affordable than you think.

What to Expect from Breast Reconstruction Surgery

Here at the Plastic Surgery Center of Nashville we offer several different options for breast reconstruction. Your surgeon will discuss which option will work best for you. Not all options are available for all women.

  • Breast Expander to Gradually Stretch Skin- One breast reconstruction option uses a balloon like expander to slowly stretch the skin over a period of weeks or months. Salt water solution is gradually injected into the expander using a special valve. Once the skin is stretched, the expander is replaced with an implant during a second surgical procedure. Nipple and areola reconstruction are performed separately.
  • Skin Flap Using Tissue from Other Parts of Body- This option creates a skin flap using tissue from other parts of the body (often the lower abdomen or back). The transplanted tissue (which consists of skin, muscle, and fat) creates space for an implant. In some situations the tissue can form the breast mound without the need for an implant.

Breast reconstruction surgery often requires multiple procedures (for example one surgery to place the expander, another to replace it, and surgery to reconstruct the nipple and areola). Typically the first surgery is the most complex. We are happy to discuss your options with you and help you determine which breast reconstruction surgery will best suit your needs.

If worries about the cost of breast reconstruction have you worried, come in and see us today. Often your insurance plan will cover the procedure, helping you to get your body back after cancer or other diseases. The skilled and sensitive surgeons at the Plastic Surgery Center of Nashville look forward to helping you love your body again.