When breast reconstruction is merely for cosmetic reasons the procedure is not considered medically necessary and would not be covered.
Breast reconstruction surgery is normally covered by Medicare following cancer treatment that includes a radical mastectomy. In some cases Medicare may cover breast reduction and reconstruction when the surgery is done out of medical necessity.
Medicare will pay for breast reconstruction to repair the breast after injury, to improve the function of the breast, or to reconstruct one of both breasts after a mastectomy. Medicare will also cover the post surgery brassiere. This applies to elective (prophylactic) mastectomy for those with strong genetic markers to get breast cancer, as well as those who had the mastectomy as treatment for breast cancer.
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Breast reconstruction surgery is normally covered by Medicare following cancer treatment that includes a radical mastectomy. In some cases Medicare may cover breast reduction and reconstruction when the surgery is done out of medical necessity.