Insurance coverage for explant...

[Guest guest]

My insurance covered my explant, and I consider myself quite lucky that they

did. It was not due to a rupture, but rather because my explanting surgeon

wrote a letter that stated I had Baker IV contractures. He did not even mention

that my implants were saline.

(The Baker scale is used to measure degrees of contracture of the capsule around

the implant, from I to IV. IV is the worst, and is assumed to present problems

in diagnosing breast cancer on mammograms, and therefore interfering with proper

preventative care.)

I don't know if, in fact, I had Baker IV contractures. (He did not tell me

that....I found out after requesting copies of the medical records.) I was just

so happy it was covered.

I don't know if the situation has changed much, but I believe that if the

plastic surgeon cares enough and knows enough to word the insurance request

letter properly, ANY explant should be covered. I know that Dr. Kolb has

expertise in getting explantation covered by insurance companies. (She also is

completely knowledgeable of the whole explant process, is skilled, and is one of

our heroes when it comes to the fight against breast implant issues.)

I think that most plastic surgeons won't deal with insurance because they get

paid less, and it's a hassle, when most of their work is cash basis anyway. I

think it is a crime that anyone has to go through this explant process without

the benefit of compassionate caretakers, from the insurance companies to the

office staff to the plastic surgeons themselves. I am so thankful for the

caring doctors that we do know about.

I hope all of you waiting can get your explants as soon as possible!!

Patty

>

> Insurance will ONLY cover explant if there is imaging proving that there is a

RUPTURE.  It's all about being medically necessary.

>