Are Breast Implants Covered by Health Insurance?
Health insurance does not generally cover breast implants done for strictly cosmetic reasons, although they may cover those done in response to a mastectomy due to breast cancer. Even if your breast implants are covered under your insurance, there may be related costs that are not covered.
You may also find that some insurance companies will not cover future procedures, such as mammograms, if you have breast implants. They also may not pay for any procedures done to correct breast implants gone wrong or any infections or medical conditions caused by the implants.
What Costs are Related to Breast Implants?
In addition to the actual surgical procedure there are a host of other costs related to breast implants that may be billed separately above and beyond the surgical procedure. If your health insurance does not cover the surgery itself, it is unlikely to cover the related costs.
The costs may include a hospital stay if your procedure is done as an inpatient surgery, the cost of local or general anesthesia, and any extended time in the hospital due to complications after surgery. Pain medication following surgery may also be on the list, as may additional surgeries down the road.
If you opt for silicone gel-filled implants, an additional cost may involve regular MRI exams recommended by the FDA. The FDA suggests women with these implant types get an MRI screening three years after the initial procedure and every two years after that first screening. Regular MRI screenings can help prevent complications stemming from what is known as “silent ruptures.” Silent ruptures occur when the implant ruptures but shows no outward symptoms.
You may also find your mammograms may no longer be covered if you have implants. Implants can require additional X-ray images beyond a typical screening, which increases the cost of the overall procedure.
Your future coverage may also be affected if you ever need breast cancer treatments. Implants may make treating breast cancer more complicated and costly and your health insurance plan may not pick up the additional costs.
One final question to ask your insurance company is about your rates. Some plans may increase your premium if you opt for breast implants.
Then there are the most restrictive case scenarios. In some cases, health insurance companies may opt not to renew your existing health insurance policy while others may reject your application if you’re seeking a new plan.
Food for Thought Before Getting Breast Implants
Breast implants are not a one-time deal (according to the FDA) and most require eventual removal or additional operations. Unless the implants you have removed are replaced with new implants, your breasts may no longer retain their natural shape and instead end up wrinkled, dimpled, puckered, or with tissue loss.
They also have a chance of not looking exactly as you imagined, or even producing irreversible damage or distortions to your breast. One more risk is an increased chance of developing a type of cancer known as anaplastic large cell lymphoma, the FDA reports. This type of cancer, although rare, develops in the tissue around the implant. It is not breast cancer per se but still may require surgery, chemotherapy, or radiation treatments.
All breast implants make it imperative for you to keep a strict eye on them for any changes, pain, or other anomalies. They may also require some type of follow-up procedures or care if you happen to develop complications.
What Complications May Develop?
The FDA points out a veritable laundry list of complications that can arise from breast implants. The most extreme may result in implant removal, while others may involve some type of reconstruction.
One of the most common complications is capsular contracture, which involves the tightening of the breast tissue surrounding the implant. It can result in pain and hardening and squeezing of the implant. Pain in general is a potential complication, as are delayed wound healing, implant deflation, and irritation or inflammation due to infection.
Your breast implants could end up asymmetrical, with one side larger, lower, or shaped differently than the other. The skin around the implant can shrink or thin out, or the implant could become visible through the skin if the skin tissue breaks down completely.
Surrounding tissues can be damaged during the procedure or your chest wall could appear deformed. Hard lumps of calcium can form beneath the skin surrounding the implant, a development that may resemble cancer. You could also end up with bruising and swelling if blood or fluids collect near the surgical site or implant.
The implants could shift, either during or after surgery, and move out of their original, intended location. Sagging, redness, skin rashes, and swollen lymph nodes can also develop, as can a change in sensation or feeling in the breast area.
Although breast implants are considered medical devices and must be approved by the FDA, that doesn’t mean they come without any potential complications or side effects. The FDA suggests reviewing the comprehensive list of complications included with each breast implant that has been approved for use by the agency.