Breast Implant Warranties and Insurance Coverage

So who pays for all this?  The cost of implant surgery may be partially or completely offset if they leak or you develop a capsular contracture requiring correction because of implant warranties.  These have changed over the years but have generally become more generous. 

If you’re not having problems but simply need a “tune up” (size change, breast lift, etc.) then the warranties won’t apply. 

If an implant leaks the manufacturers have always provided a replacement at no cost.  In fact, they will usually provide two, so both implants can be replaced.  If they fail within a certain period of time after initial placement, usually 10 years, they also will provide some additional funds to offset the cost of your surgery. 

This varies by manufacturer and when the implants were placed.  It requires some paperwork by the patient and surgeon but we know how this works and can assist in the process.  We did have a patient that had implants placed in Europe from a small manufacturer there. 

They couldn’t provide implants to us for replacement as they aren’t approved in the US and we can’t legally place them. 

Insurance issues are trickier.  An implant failure in a patient who originally had implants placed for reconstructive reasons is nearly always covered by insurance but some revisions (size change, lifts, etc.) may not be. 

We send a predetermination letter prior to surgery so we can be sure of your coverage.

Implant problems which develop years after implants are placed for purely cosmetic reasons are typically not covered. 

Insurance company policies vary, so you may want to check your own policy for details.  However, we have seldom seen these procedures covered in cosmetic patients.

We always work with our patients and try to help them navigate their warranties and insurance issues as best we can to keep our procedures affordable.

Next: Capsular contracture