Q: I need breast implants to make my breasts more even. I think insurance should pay for them because I think my genes didn’t have them grow right. They are quite uneven. My left breast is about a C cup and my right breast is just a small B cup. I think two different sized breast implants would work to make them both D cups. What do you think are the odds my breast implant surgery will get covered by my health insurance?
A: Quite frankly, I think those odds are as close to zero as you can get. Despite your wanting breast augmentation to be a reconstructive procedure, it is not. Breast asymmetry, despite it causing some understandable anguish and embarrassment, is not viewed as a congenital deformity. (caused by ‘poor genes’) It is viewed by health insurance companies as both cosmetic and elective. There was a day many years ago when they may have in some severe cases prior to 2000, but those days have long passed now.) For insurance to cover breast implants, it would have to be done for reconstructive purposes which insurance views as due to cancer resection or a traumatic injury. Breast reconstruction is viewed as a medically necessary surgery in cases of lumpectomies and mastectomies. Incredulously, I have numerous cases today where insurance even fights covering it when cancer is involved!
Dr. Barry Eppley