Will Insurance Cover Replacement Of My 30 Year-Old Breast Implants?

Q: Dr. Eppley, I am 66 years old. I have had breast implants for approximately 30 years and would like to have them removed.   I have Medicare / Anthem insurance, but I don’t know if they will cover this.  I would like to know how much this procedure would cost if I paid for it (without insurance). 

A: Congratulations on the longevity of your breast implants. Although at the time they were placed you probably thought they would last a lifetime, few patients ever do and one could predict a 10 to 20 year lifespan until the devices fail and have to be replaced. Thus you have done well. You did not state why you wanted your breast implants replaced. Is there a particular problem with them or is this just an aesthetic issue? Replacing them with new silicone implants will have total costs in the range of $5800. Issues to be considered are new size and style of the silicone gel breast implants and whether they should stay in their existing anatomic location (above or below the muscle) or be changed.

Your assumption is correct about insurance coverage. Breast implants are only a covered medical procedure if they are being done as part of a breast reconstruction after cancer or part of a revision of a prior breast reconstruction procedure.

Dr. Barry Eppley

Indianapolis, Indiana