A member asked:

Is breast augmentation ever covered by insurance? are there any circumstances in which insurance would pay for breast augmentation?

13 doctors weighed in across 7 answers
Dr. Mia Skourtis answered

Specializes in Surgery - Plastics

Breast : Breast augmentation is almost always considered a cosmetic procedure, meaning that it is done to improve appearance and not to treat a medical condition. Circumstances where breast implants might be covered by insurance are those in which the procedure is considered reconstructive, such as following removal of breast tissue for breast cancer, or to treat abnormal breast development (total absence of one breast, or abnormal constriction of the breast skin and tissue). All the best, dr. Skourtis.

Answered 10/3/2016

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Dr. Leonard Grossman answered

Specializes in Plastic Surgery

It : It may be possible in some cases of severe asymmetry and only if you are lucky to get the approval. As a rule, augmentation is a cosmetic procedure and is not covered by insurance. Good luck from nyc. For more info visit www.Drgrossman.Com.

Answered 10/4/2016

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Rarely: It is generally very rare for a third party payor to cover the costs of elective cosmetic breast augmentation unless performed for reconstructive purposes.

Answered 1/12/2013

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Dr. Jeffrey Roth answered

Specializes in Plastic Surgery

Rare issues: Cosmetic breast augmentation is rarely, if ever, paid by health insurance. A breast implant may be necessary in a reconstructive case. See a board certified plastic surgeon. They will guide you through the process. http://www.jjrothmd.com/before-after/category/breast-augmentation.

Answered 7/30/2013

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Only for transgender: Breast augmentation for females is considered a cosmetic operation, and therefore insurance will not cover the costs. However, some insurance companies will pay for male patients, who are in the process of becoming female, to undergo breast augmentation as part of their gender reassignment.

Answered 10/4/2016

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Dr. Joseph Mele answered

Specializes in Plastic Surgery

Rarely: The vast majority of breast augmentations are performed in healthy women who want larger breasts. For this cosmetic group, insurance is not involved. For breast reconstruction after cancer surgery, burns, trauma or birth defects insurance should play a role. Prior authorization must be obtained in all cases.

Answered 10/24/2017

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Sometimes.: Breast augmentation can be covered in some situations where there is significant asymmetry in breast volume or shape due to breast underdevelopment unilaterally, some syndromes with underdeveloped chest muscle and breast etc....Obviously they are covered in women following breast cancer.

Answered 4/5/2014

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