Medicare and Medicaid coverage of risk-reducing surgery varies
Medicare’s policy is that you must have signs or symptoms of cancer to qualify for surgery. For this reason, Medicare generally does not cover preventive surgeries although people in some regions have succeeded in getting coverage.
Visit the Medicare website or call 1-800-MEDICARE (1-800-633-4227) to learn more about what your plan covers and how to manage claims and appeals.
Medicaid coverage of risk-reducing surgeries such as mastectomy (removal of breasts), hysterectomy (removal of uterus) or salpingo-oophorectomy (removal of ovaries and fallopian tubes), as well as breast reconstruction after mastectomy varies by state.
Contact your Medicaid office to learn more about access to these services in your state.