Will Health Insurance Cover Breast Augmentation

Breast augmentation, also called augmentation mammoplasty, is an elective cosmetic surgical procedure that aims to enlarge your breasts or achieve symmetry.

Regardless of your motivations for desiring augmentation mammoplasty surgery, being aware of the associated costs is essential.

Several factors influence a surgeon’s pricing, such as experience, augmentation type, and geographic location.

Insurance for breast augmentation
Insurance coverage for augmentation mammoplasty: Photo courtesy (Healthline)

Frequently, patients inquire about insurance coverage for breast augmentation.

The American Society of Plastic Surgeons declares that most health insurance plans generally do not cover expenses, complications, and revision surgery for cosmetic breast augmentation.

Yet, there are instances where insurance may provide coverage.

If your procedure is deemed reconstructive rather than cosmetic, it could be eligible for insurance coverage.

When Does Insurance Cover Breast Augmentation?

Cosmetic breast augmentation rarely gets insurance coverage.

Mastectomy patients due to cancer may receive partial insurance coverage for the procedure.

How Much Does Breast Augmentation Cost?

Typically, it costs around $6,550, covering surgeon, operating room, and anesthesia fees.

Insurance doesn’t cover cosmetic cases, so patients need to make full out-of-pocket payments.

Surgeons could propose payment plans for early surgery, which you can discuss when booking.


Cosmetic surgery involves enhancing one’s appearance through various procedures.

For instance, if you’re considering breast augmentation to enhance your swimsuit appearance, your surgery falls under the category of cosmetic procedures.

Additional instances of cosmetic surgeries encompass rhinoplasties undertaken to decrease nose size, as well as implants in areas such as the chest or calf, and rejuvenating facial treatments like facelifts.

Numerous legitimate motivations may drive your interest in these surgical interventions, offering you a diverse array of choices.

However, if insurance doesn’t deem these procedures medically necessary, they won’t provide coverage.


If it is medically necessary, it’s usually covered as breast reconstructive surgery.

Coverage depends on the specific procedure and your insurance.

Reconstructive surgery includes addressing functional issues and deformities.

Insurance providers cover augmentation mammoplasty after mastectomy (due to breast cancer) because they consider it a reconstructive procedure.

Reconstructive breast augmentation
Reconstructive augmentation mammoplasty: Photo courtesy (Forbes)


The meanings of cosmetic and reconstructive terms are always changing.

“Deformity” now includes not just rebuilding post-mastectomy breasts but also matching the other breast’s appearance.

Post-reconstruction, women can get coverage for elective aesthetic revision surgery, like changing surgical methods or updating implants.

Remember, patients must collaborate with their insurer.

Some cover breast implant revisions up to eight years post-reconstruction, others for a shorter time.


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