Breast Reconstruction & Health Insurance Options

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Thousands of women are diagnosed with breast cancer each year and often,the cancer cannot be eliminated by a lumpectomy. Breast cancer or trauma to the bust can damage your self image and self-confidence. If you have had breast cancer or other accidents that have altered the shape of your breasts, a plastic surgeon can help rebuild your bust and help you regain a sense of symmetry and proportion to your body.

Recent technological advanced in reconstruction procedures provide many options for women facing mastectomy.The reconstruction process can involve the use of saline or silicone implants as a prosthesis, or even the body’s own tissues from the abdomen. Before your surgery, be sure to discuss the reconstruction technique with your surgeon and determine which option suits you best.

Understanding the cost of the procedure is very important, because costs can vary based on the experience of the plastic surgeon as well as the geographic location of the surgery. The costs include the fees paid for the surgeon, hospital costs, anesthesia, prescriptions, any special clothing or dressings need, medical tests or x-rays.

Even though the fees for surgery can be expensive, you should always choose a reputable plastic surgeon who has had considerable experience in the field or breast procedures and fulfilled adequate training requirements. Ask to see his track record of success in plastic surgery.

If you are recovering from cancer and need reconstructive surgery, much of the fees should be covered by your provider. Many surgeons offer financing plans to help alleviate some of the costs. Consult your plastic surgeon and your health provider to determine if your procedure is covered by your plan.

The Women’s Health and Cancer Rights Act of 1998 was established to provide coverage to women whose health plans are not required by state law to cover the costs of breast reconstruction. Women who have questions about financial coverage of reconstruction procedures should call their health provider, the Department of Labor, or their State Insurance Commissioner’s office.

The 1998 Federal Breast Reconstruction Law states that all health insurance companies must cover reconstruction of the breast during a mastectomy and surgery and reconstruction of the other breast to produce a symmetrical appearance, breast prostheses and treatment of complications from mastectomy, such as chronic swelling. In addition, many states have their own unique laws which explain what is covered during a mastectomy.

Before the surgery, it is very important that you determine whether insurance will cover your surgery fees. You certainly do not want to be surprised by any unanticipated costs. If you have health insurance, the carrier should pay for your procedure. If you do not have insurance, you should talk to your surgeon and the hospital about negotiating a discount rate. Many are also able to qualify for health insurance under state Medicaid program or other health-coverage programs for low- and moderate-income individuals.

Many women opt for reconstruction surgery after other procedures, not having to do with a mastectomy. However, you should investigate whether all of the fees are covered by health insurance. If not, you may have to pay out of pocket. Make sure you talk to your health insurance company as well as your doctor to understand what fees are covered, and understand the risks of having the surgery.