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Insurance coverage for prophylactic surgeries?


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Question from Ang: I am concerned about the cost of elective surgery. Will my insurance cover the cost of removal of breasts and/or ovaries?
Answers - Beth Baughman DuPree, M.D., F.A.C.S. If the woman's risk is such that prophylactic surgery has been suggested by either her surgeon or medical oncologist, I have found that most insurance companies will provide coverage for that surgery as it is not considered elective but prophylactic. I personally would not perform a prophylactic surgery on a patient who did not have significant risk of breast or ovarian cancer.
Lynn Hartmann I agree with Dr. DuPree. Occasionally the insurance companies will balk at reimbursement, but if the physician provides documentation of the need for the surgery, they usually do provide coverage.

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