Will Insurance Cover My Breast Surgery?

NJ Breast Surgery Specialist – Dr. Zubowski
Breast Implants and Insurance Coverage

Many patients find that their insurance plans do not cover all plastic surgery procedures. Since procedures such as facelifts, tummy tucks, and breast enlargement are performed for aesthetic reasons – and therefore considered “elective” – these procedures are not included in most insurance plans’ covered benefits.

Many women have breast surgery because of aesthetic reasons – they are unhappy with the size or shape of their natural breasts. Insurance plans typically do not cover surgery that is performed for aesthetic reasons. However, other women choose to have breast surgery for health reasons. Many women with extremely large natural breasts experience back pain and posture problems. In cases where these women’s physicians examine them and determine that breast reduction surgery would alleviate these problems, insurance may pay for some or all of the surgery.

Whether or not insurance will cover breast reduction surgery depends on the insurance company and the patient’s particular situation. It is wise for patients to consult with their physician and their physician’s billing department to talk about options for billing insurance plans. An experienced billing professional can provide more detailed information.

Another breast surgery which may fall under insurance plans’ covered benefits are breast reconstruction cases. These cases arise when a woman has been diagnosed with breast cancer, and had one or both of her breasts removed as part of treatment (this is called a mastectomy). These women wish to have breast implants placed to restore the fullness and symmetry that they once enjoyed. Some insurance plans may cover the costs of breast reconstruction, but it is very important to discuss this option with your physician’s office and your particular insurance company. They can provide more detailed instructions and information.

There was legislation passed in the late 1990s which entitled women who undergo mastectomies to insurance benefits which cover breast surgery. The specifics of this legislation may vary from state to state, or among insurance companies, so contact Dr. Zubowski’s plastic surgery New Jersey offices to learn more.

Dr. Zubowski has completed many years of advanced education and specialized training. This background allows him to confidently offer an array of procedures for the breast, face, and body. Individuals he consults include body contouring New Jersey patients seeking liposuction, tummy tuck, and/or arm lift. In addition, Dr. Zubowski is renowned throughout the tri-state area as a foremost New Jersey rhinoplasty and facelift expert.