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The Truth About Breast Implants & Medical Insurance

The cost of breast implants, which is the medical term used to describe a surgery to increase the size of a womanís breasts, is high. Therefore, the majority of patients who desire to have breast implants surgery are turning to their private insurance companies for coverage. Prior to being accepted as a candidate for a breast implants procedure, the patient must undergo an evaluation with their physician. This may include a physical, a look into the patientís past medical history and a determination of why the patient wishes to have this type of surgery. The patient will be informed by both the surgeon and primary care physician about the benefits, risks and overall outlook following surgery. Before moving forward, the patient should contact his/her private insurance carrier in order to determine if their policy covers this type of surgery.

The problem that many patients encounter is, because breast implants is a form of plastic surgery, many insurance companies will not cover the cost of this procedure. If breast implants are included in their policy, the next step will include submitting letters of recommendation to the insurance carrier. This letter will be sent directly from your surgeon or physicianís office and will request financial approval for the breast implants. Along with this letter, a copy of the patientís medical records will also be submitted. The patient will be responsible for gathering much of his/her medical records and receipts, so it is a good idea to begin gathering this information as soon as possible because letters of recommendation cannot be submitted without it.

Following the submission of recommendation letters, most physicians expect a response within several weeks. Depending on the insurance carriers, however, decisions can take anywhere from two weeks up to several months. In the event that a denial is issued, the physician will typically continue working with the patient to provide additional information expressing the need for breast implants surgery. If the patient is continually denied for coverage, it may be necessary to seek alternate funding options. This may include a payment plan offered by the hospital, which requires that the patient accept the financial responsibility for the surgery in the form of monthly payments. A bank or credit union loan may be another option, but will depend on the patientís credit history and other factors as to whether the loan is approved or denied. This article is intended to be used for informational purposes only. It should not be used in place of, or in conjunction with, professional medical advice. Anyone considering a breast implants procedure must consult a licensed physician for a proper determination and further information.


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