Ask the Doctor-Have you seen insurance cover a mastectomy and reconstruction under BCBS?

This week, James E. Craigie, MD, of The Center for Natural Breast Reconstruction answers your question.

Question:  I have an overwhelming history of breast cancer in my family (2aunts and grandmother ovarian cancer). My mother was diagnosed at age 50 before menopause and had to have chemo and radiation. I have BCBS of SC health insurance and it looks like the genetic testing is covered under medical necessity.

If I test positive I wanted to explore my options and know my coverage. Have you seen insurance cover a mastectomy and reconstruction under BCBS of SC for someone who has not been diagnosed but tests positive? Thanks for your help.

Answer: Thank you for your question. Yes we have had many patients who had negative genetic testing who have had preventive mastectomies and immediate breast reconstruction.

You should discuss your risks and history with a breast surgeon. They will let you know what the insurance company requires. If you are approved for a preventive mastectomy then reconstruction will be covered as well.

Have a question about breast reconstruction or post-surgical you’d like answered from our surgical team? Just ask!