Does insurance cover breast reconstruction?
Because of a US federal law passed in 1998, all insurance carriers are required to cover breast reconstruction for patients who have a breast cancer diagnosis. While your breast reconstruction may be a covered benefit, there may be variable costs associated with breast reconstruction based on your insurance, your co-pay costs, and any applicable coinsurance fees.
Breast reconstruction after prophylactic (preventive) mastectomy is often covered as long as the patient is deemed high risk for breast cancer (a patient with a significant family history of breast cancer or who has tested positive for the BRCA gene).
If you’re getting reconstructive breast surgery for any other reason, insurance likely will not cover the costs. Many surgeons offer patient financing plans to make the procedure more affordable.
How much does breast reconstruction cost?
Breast reconstruction costs vary greatly by surgeon, geographic area and the type of procedure. Costs also vary based on whether you are having one breast or both breasts reconstructed.
Below outlines the types of reconstructive breast surgery from least to most expensive:
- Breast Reconstruction Using Implants (least expensive)
- Breast Reconstruction With Implants Using an Acellular Dermal Matrix
- Breast Reconstruction Using Natural Grafts/Tissue Flap surgery (most expensive)
The average cost for breast reconstruction surgery is $49,489*. However, it’s worth noting this number can be misleading as insurance typically covers at least some of these costs.
*The above statistics come from the 2020 Aesthetic Plastic Surgery National Databank Statistics, which were compiled using Aesthetic Neural Network (ANN) data from 288 participating plastic surgery practices across the US. These numbers only reflect standard procedure costs (surgeon and facility fees) and may not include fees for anesthesia, medical tests, prescriptions, surgical garments, or other miscellaneous costs related to your procedure(s).
Be sure to ask your surgeon what your approximate costs will be for your specific breast reconstruction during your consultation.
What should I consider when evaluating the cost of breast reconstruction?
Choose your surgeon based on quality, training, and experience—not cost.
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