Will Insurance Cover A Breast Lift Wth Implants Due To Skin Problems?

Q: Dr. Eppley,  I have a problem with sores on my breasts. My breasts are very small and extremely saggy having lost most of my breast tissue after breastfeeding four  children. I kid you not that they are literally two sacks of skin just hanging there. When I wear a bra they get all bunched up inside it and are folded unto themselves. This causes the skin and particularly my nipples to rub and get weepy,oozing painful areas. Due to these sores, is it possible that I would qualify through my insurance to have a breast lift with implants covered? It would seem that insurance should cover it since it is causing a medical problem. What do you think?

A: Medical insurance will never cover any breast procedure that involves a lift or implant, unless it is part of a breast reconstruction due to breast cancer. While it would seem logical that your skin problems would provide the reason for a surgical solution, that will not happen. Insurance will cover the medical treatments for your breast skin problems but not for breast lifts whether implants are used or not. This will be viewed as a cosmetic procedure, not a reconstructive one.

Dr. Barry Eppley

Indianapolis, Indiana