Health Insurance (and Medicare and Medicaid)
Insurance companies cover services that they determine to be “medically necessary” to treat a disease or illness. Although you or your doctor may believe a service is medically necessary, insurance companies don’t always agree.
Many companies consider removal of breast implants medically necessary for patients with any of these conditions:
- Ruptured silicone gel breast implants
- Severe capsular contracture
- Infections that don’t go away
- Chronic breast pain
- Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL), a cancer of the immune system)
Unfortunately, insurance companies generally won’t cover the cost of breast implant removal for autoimmune or connective tissue diseases or other systemic complications.
Obtaining coverage for your implant removal differs depending on the type of insurance you have. Medicare and Medicaid also cover implant removal that they consider medically necessary. To learn more about trying to get insurance coverage for removal, click here.
Currently, there are no open class action lawsuits relating to implants. Because most women getting implants are asked to sign informed consent documents prior to their surgery, it has become very difficult for lawsuits to proceed. Recently, however, the number of individual lawsuits against breast implant makers has increased. If you believe you may have a claim against an implant manufacturer, you may want to speak to a lawyer who has experience with this type of case.
All articles are reviewed and approved by Diana Zuckerman, PhD, and other senior staff.