When you are opting for breast reconstruction surgery, there are many factors that you will take into consideration, such as, the type of reconstruction surgery that you want to opt for, when you should have the surgery, where do you want to have the surgery, and the experience and qualification of the plastic surgeon. Besides these factors, there is another very important factor that you will have to take into consideration- the cost of breast surgery.
When you are planning your breast reconstruction surgery, you obviously want to know how much the breast reconstruction surgery will cost and whether your insurance cover will cover the cost or not.
There are many factors that influence the overall cost of breast reconstruction surgery. Understanding these factors will help you find the true cost of the surgery beforehand.
One of the first things that you should be clear about is that the cost of breast reconstruction surgery varies from one geographical location to another. For example, in cities the cost of breast surgery is going to be high as compared to suburbs, rural, and other areas. The cost will also vary from one city to another.
Not only this, the cost will vary from one country to another. For example, cost of breast reconstruction surgery is much lower in countries like, India, Mexico, Singapore, and Ukraine as compared to US and UK. The flap breast reconstruction surgery will cost around $2,000 in India, while the same surgery will cost you above $7,000 in US.
Type of Breast Surgery and Cost
The cost of the surgery also varies according to the type of surgery you want to have or is recommended by your doctor. For example, breast reconstruction in US using a single implant will cost around $3,000, while a TRAM flap surgery will cost above $7,000. Latissimus dorsi (upper back) flap surgery costs around $6,000. If you are having your nipple reconstructed also, it will cost you additional $1,200. Nipple reconstruction using tattoo costs around $600.
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Overall, breast implant reconstruction surgeries cost less than tissue flap reconstruction surgeries. The reason behind this is that tissue flap surgeries involve complicated procedures and require longer hospital stay. Moreover, tissue flap breast reconstruction surgeries are usually done by surgeons who are best in this field. They are obviously going to charge you more.
Surgeon’s Qualifications and Experience and Cost
The cost of breast reconstruction surgery also depends on the surgeon’s experience and qualification. A highly qualified and experienced surgeon who is also board certified is likely to charge you more than a surgeon who does not have so much experience or is not highly qualified.
Here it is important to clarify that you should not choose a surgeon simply on the basis of cost. You need to keep in mind that a highly qualified and experienced plastic surgeon will be able to do a good job of reconstructing your breasts and minimize the possibility of side effects.
If you opt for a surgeon who is not experienced, qualified and/or board certified, there is a highly possibility that you will be left with a botched up job and you might have to go for another surgery. In that event, you will simply end up paying more. Therefore, when choosing a surgeon for breast reconstruction, make sure that you balance the cost, qualification, and experience properly.
The total cost of breast reconstruction surgery includes the surgeon’s fee, hospital cost, anesthesia cost, x-rays and medical tests, medication cost, implant cost, cost of surgical garments that you will require after the surgery, follow up care, and other miscellaneous expenses. When you are trying to figure out how much the surgery will cost you, you need to make sure you include all the expenses.
Time of Surgery and Cost If you are having breast reconstruction surgery during your mastectomy surgery, the overall cost of the surgery is likely to shoot up. When mastectomy surgery is immediately followed by a breast reconstruction surgery, it requires longer hospital stay and recovery time.
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A longer hospital stay obviously means that you will have to pay more for the surgery. Longer recovery time means that you will need more prescription medication, follow up care, post-surgery supportive garments and medical tests and these will all push up the overall cost of the surgery.
The good news about breast reconstruction surgery is that your insurance is likely to cover major part or all the cost of the surgery. The Women’s Health and Cancer Rights Act of 1998 makes it mandatory for health insurance providers to cover the cost of breast reconstruction.
This law established that breast reconstruction surgery will not be considered cosmetic surgery for those who are having this surgery due to mastectomy or trauma.
Check with Your Insurance Provider
Check with your insurance provider and find out what part of the overall cost will be covered by them. Some insurance plans only provide for certain types of breast reconstruction procedures. Therefore, make sure that your insurance cover provides for the breast reconstruction procedure that you are about to have.
Also make sure that the surgeon you have selected is on the list of in-network surgeons of your insurance plan. However, if you are having a complicated breast reconstruction surgery involving tissue flap, there is a possibility that an in-network surgeon might not be qualified enough to perform the surgery. In this case, you will have to opt for an out-of-network plastic surgeon. If this is the case, you will need to find out from your insurance provider what part of the overall cost they will cover.
Insurance Coverage for Surgery on Unaffected Breast
In many cases surgeons also have to do breast reconstruction surgery on the unaffected breast in order to make both the breasts symmetrical in size and shape. Since the June of 2010, insurance providers are required to cover such types of surgeries. Even Medicaid provides benefits for such types of surgeries.
If you are doing breast reconstruction surgery following a preventive mastectomy, your insurance provider will cover the cost. You will need to provide proof that the preventive mastectomy surgery was done, because you were at high risk for developing breast cancer in the future.
Coming Up With the Right Estimate
If you take into consideration all the factors, you will be able to figure out exactly how much your breast reconstruction surgery will cost you and you will be able to plan your expenses accordingly. Once you figure out how your breast reconstruction expenses will be covered, you will feel secured and will be able to focus on your cancer treatment and recovery. So talk to your surgeon and insurance provider today to find out how much the surgery will cost you.