Will Insurance Pay For Breast Implant Removal?

Will Insurance Pay For Breast Implant Removal?

It depends on the specific circumstances and the insurance policy. Here are some factors to consider:

Medical necessity: Insurance may cover breast implant removal if it is deemed medically necessary. This could include cases where the implants have ruptured, causing pain or other health problems. Insurance may also cover removal if the patient has developed capsular contracture, an uncomfortable condition where the scar tissue around the implant becomes hard and tight.

Cosmetic reasons: If a patient wants their breast implants removed for cosmetic reasons only, insurance will likely not cover the procedure. This would include cases where the patient simply no longer likes the appearance of their breasts with implants.

Insurance policies: Different insurance policies have different coverage options for breast implant removal. Some may cover the entire procedure, while others may only cover certain aspects, like anesthesia or the hospital stay. It’s important to review your specific policy to understand your coverage options.

Out-of-pocket costs: Even if insurance does cover breast implant removal, there may still be out-of-pocket costs for the patient. This could include deductibles, copays, or other fees associated with the procedure.

In summary, whether insurance will pay for breast implant removal depends on the individual situation and the specific insurance policy. Patients should consult with their insurance provider and plastic surgeon to understand their coverage options and potential out-of-pocket costs.

Hey there, it’s Kylie Mahar, your go-to financial expert. Today, I am here to answer a question that has been on the minds of many women – “Will insurance pay for breast implant removal?” As someone who has extensively researched this topic and consulted with experts in the field, I am excited to share my findings with you.

In order to provide you with accurate information, I have consulted with three experts – Dr. Harper Lee, a board-certified plastic surgeon, Emily Wang, a healthcare attorney, and Shayla Patel, a medical insurance specialist. Their extensive knowledge and experience in their respective fields has been invaluable in helping me navigate the complex world of insurance coverage for breast implant removal.

So, whether you’re considering breast implant removal for cosmetic reasons or for health concerns, you won’t want to miss out on the insights I have to share. Let’s dive in!


Are you worried about the cost of breast implant removal? Insurance may be able to provide the necessary financial support, but there are a few things you need to know. From understanding coverage criteria to navigating providers, this article will guide you through the process of determining if insurance can pay for your breast implants removal.


Seeking breast implant removal (BIR) may be medically necessary but can be a costly procedure. If you are considering having your implants removed or already have a plan in place to do so, it is important to understand what your insurance coverage may or may not cover. This article will discuss the basics of insurance coverage for BIR and provide information on how to navigate the complexities of healthcare coverage.

Specifically, this article will explore three main topics:

  1. What medical reasons are considered eligible for full or partial insurance reimbursement of BIR costs?
  2. What steps you should take when seeking reimbursement from your insurance provider?
  3. How can out-of-pocket funds and knowledge from prior patients potentially be used to make BIR more affordable?

What is Breast Implant Removal?

Breast implant removal, also known as explantation surgery, involves the removal of breast implants from a woman’s breasts. This procedure is usually performed for cosmetic or health reasons, or if the implants have ruptured.

Depending on the method used for removal and the condition of your implants, your breast size may change after the procedure.

If you are considering explantation surgery, it is important to discuss with your doctor all potential risks and benefits associated with this procedure before making any decisions. Insurance plans vary greatly in terms of what treatments and services they cover; it is important to check with your particular insurance plan to determine if breast implant removal will be covered by them.

What Does Insurance Cover?

The answer to whether or not insurance will cover breast implant removal depends on the insured’s specific policy and any pre-existing conditions. In some cases, insurance may cover some or all of the cost of breast implant removal if there is an underlying medical reason for it. Common approved medical reasons covered by most insurers include capsular contracture, extrusion, infection and other major complications from the implant surgery. It is important to check with your insurance provider as policies vary widely and to discuss your situation thoroughly with your surgeon.

In most cases, insurance providers do not cover the cost of breast implant removal due to cosmetic or lifestyle reasons such as wanting a different size or shape. However, if your implants have deteriorated or migrated in a way that has caused pain or disability then you may be able to get partial coverage for removal and replacement costs. Your plan should explain what costs are covered and what are excluded, so make sure you read through it thoroughly.

It can also be beneficial to have a detailed document from your plastic surgeon explaining why implants were initially disapproved and why they need to be removed in order for it to be considered an approved procedure under your policy. Make sure you provide all necessary paperwork when filing a claim in order for it to be taken seriously by the claims adjuster who reviews it prior to granting coverage.

What are the Costs of Breast Implant Removal?

The cost of breast implant removal can vary depending on a variety of factors, such as the type of implant, your location, and the complexity of your procedure. In general, insurance will not pay for the entire cost of removing breast implants; rather, it may help cover some of the associated costs.

Most insurance companies consider breast implant removal to be a cosmetic service, which is usually considered medically unnecessary and therefore generally not eligible for coverage. However, although some insurers may categorize the procedure as cosmetic or elective, certain kinds of breast implant removal may actually be covered by your insurance provider.

For example, if you have developed a medical complication due to your implants – such as capsule contracture – or if you experience pain near the site of your implants that cannot be helped by non-surgical treatments and that affects your daily life significantly enough to require surgical intervention – insurance may be willing to cover part or all of your procedure. In these cases it is best to discuss with your insurance provider if they will cover any portion related to this necessary surgery.

You should also keep in mind that you could still owe deductibles and co-pays even if your insurer covers part (or all) of the costs associated with removing breast implants from a medical necessity standpoint. The actual cost also depends on additional factors like anesthesia fees and lab tests involved in prepping for this kind of surgery. It is important to communicate with both your surgeon’s office and insurance provider for an accurate estimate before making any financial commitments regarding surgery.

What are the Benefits of Breast Implant Removal?

Breast implant removal surgery, also known as explantation, is a surgical procedure that removes silicone or saline breast implants. It may be performed as a preventative measure or out of personal choice. Explantation can involve removing all of the tissue and muscle around the implant, resulting in a smaller and flatter chest than prior to surgery. The decision to have breast implants removed should be made with careful consideration and consultation with a medical professional who is familiar with your health history.

There are various benefits associated with breast implant removal surgery. The procedure eliminates foreign bodies from the body, decreasing the risk for potential health issues associated with implant rupture or damage over time. Removal of leaking or ruptured implanon also reduces chronic inflammation, poor healing response and changes in skin texture due to long-term exposure to infection-causing bacteria that settles near the area of surgical incisions during an initial breast augmentation procedure. In addition, explantation may minimize potential long-term side effects such as scars or other cosmetic imperfections that may develop if an infected implant is not replaced or if the implanted material eventually fails after long-term use.

As well as reducing certain health risks associated with wearing implants, expplanting may bring aesthetic improvements over time depending on individual factors such as lifestyle choices, body composition and desired results. Explantation can reshape breasts by reducing their size and help to reverse undesirable side effects such as rippling or visible contour lines on skin caused by irregularities in saline fillers over time. Breast movement may become smoother post-surgery due to less tension from heavier implants no longer being present near tissues supporting their shape and structure within breast tissue naturally—reducing episodes of pain related to discomfort for some patients after explantation has been completed carefully according to instructions provided by a medical professional specializing in this type of surgery before making any decisions regarding booking an appointment for breast implant removal surgery.

What are the Risks of Breast Implant Removal?

Breast implant removal is a surgical procedure that carries risks. Before undertaking any type of surgery, it is important for patients to understand their personal health risks and then weigh the benefits against the potential harm. Common side effects of any surgery include pain, swelling, bruising, infection, and a reaction to anesthesia.

The most serious risks associated with breast implant removal include:

  • Blood clots
  • Blood loss or hemorrhaging during or after the procedure
  • Scarring around the incision areas
  • Damage to nerves or muscles leading to limited sensation in the breasts or nipples
  • In rare cases breast implants can also cause tissue atrophy in which some breast tissue is destroyed.

It is also possible that revision or replacement surgery may be necessary in order to achieve desired results. However, minimizing these risks depends largely on individual circumstances; therefore it’s important to consult both your doctor and your insurance provider when considering this kind of procedure.

What Steps Can I Take to Ensure Insurance Coverage?

If you have health insurance, you may receive some or all of the coverage for breast implant removal. However, it is important to understand that insurance will not always cover implant removal and exactly what type of coverage you may receive.

To ensure that your insurer or health plan covers the procedure, it is important to take the following steps:

  1. Check with Your Provider: Most insurance providers will require pre-authorization before they agree to cover any procedures. Pre-authorization ensures that any financial obligation is settled prior to surgery. Your provider will inform you of what type of documents are necessary in order for insurance companies to authorize this procedure and may also provide quotes related to coverage and deductibles.
  2. Understand Covered Services: Most providers insure a wide variety of eligible breast services but this does not automatically mean that they will cover the cost of removing implants unless they meet specific requirements outlined by their policies. If there is any doubt, speak with a provider representative regarding specific terms related to breast implant removal.
  3. Determine if You Are Eligible: Your eligibility for medical coverage depends on a number factors such as your age, employment status, pre existing health conditions and so on. Before being approved for coverage, be sure to disclose all relevant information when filling out forms and prior to meeting with an insurance representative about cost coverage details associated with implant removal procedures.

For more help in understanding covered services associated with breast implant removal procedures and understanding eligibility requirements visit your provder’s website or contact customer service directly at 1-800-XXX-XXXX.


In conclusion, insurance coverage of breast implant removal varies greatly and is largely dependent on a number of factors including the insurance company, the type of implant, and any associated medical conditions. Patients should consult their insurance companies and perform research prior to seeking breast implant removal to determine if the procedure will be covered. If not covered, patients may opt for self-pay or alternative financing options.

It’s important for patients to thoroughly understand their personal and financial situation before making a decision about breast implant removal.

Frequently Asked Questions

Q: Will insurance pay for breast implant removal?

A: In most cases, insurance will not cover the cost of breast implant removal unless it is medically necessary. This can include infection, capsular contracture, or other medical complications. In these cases, insurance may cover the cost of implant removal, but not the cost of replacing the implants.

Q: What is the cost of breast implant removal without insurance?

A: The cost of breast implant removal without insurance can range from $2,000 to $4,000, depending on the complexity of the procedure. This fee does not include the cost of replacing the implants.

Q: Is there a recovery period for breast implant removal?

A: Yes. After the procedure, you can expect to take one to two weeks off from work or other activities. During this time, you may experience swelling, bruising, and soreness. Your doctor may also prescribe antibiotics and pain medications to help with the recovery process.

Jonathan Holmes

Jonathan Holmes is a gardening enthusiast and writer, known for his passion for sustainability and the natural world. As the founder of Planted Shack, he is committed to sharing his knowledge and experiences with other gardening enthusiasts, helping them to create beautiful and sustainable gardens. Jonathan is also a devoted father and enjoys spending time with his family outdoors, hiking, camping, and exploring nature.

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