Breast Implant Removal and Medicare

Medicare is the federal health insurance program for:

  • People who are 65 or older
  • People under age 65 with certain disabilities
  • People with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD)

Generally, Medicare doesn’t cover cosmetic surgery unless it’s needed because of accidental injury or to improve the function of a malformed body part. Medicare does cover breast prostheses for breast reconstruction for individuals who had a mastectomy because of breast cancer.

Additionally, Medicare usually covers breast implant removal (saline or silicone) for any of these conditions:

  • Painful capsular contracture with disfigurement
  • Implant rupture
  • Infection
  • Implant extrusion (coming through the skin)
  • Interference with the diagnosis of breast cancer
  • Siliconoma or granuloma (silicone-filled lumps under the skin)

Click on this link for additional information about coverage and benefits under Medicare, https://www.medicare.gov/what-medicare-covers.

We have spoken with so many women about their troubles getting insurance coverage for these explants, that we thought it may help to put together some ideas, facts and resources that may resolve at least one part of these ordeals.

On October 2, 2019 at 10:00 am PST, please join Senior Attorneys Cari Schwartz and Elizabeth Green of Kantor & Kantor, LLP for a webinar that is designed to help you understand how to obtain insurance coverage for your breast implant removal surgery. The registration link is HERE

For immediate questions about insurance coverage for breast implant removal, please call today at (800) 446-7529 or use our online contact form.

 

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