Breast Reconstruction and FSAs

Breast reconstruction procedures can rebuild the breasts and restore a woman’s appearance after undergoing mastectomy or lumpectomy to treat breast cancer. The procedure can greatly improve a patient’s quality of life and self-esteem by giving her back the feminine figure she once had. Indeed, the decision to undergo breast reconstruction can be difficult, but after reaching this final stage of recovery, patients can finally move on with their lives. 

At Crawford Plastic Surgery in Marietta, Dr. Marcus Crawford and Dr. Steven Bailey are skilled in advanced breast reconstruction techniques. They are happy to work with patients and their oncologists in developing a post-mastectomy treatment plan. And in many cases, patients find that the costs of breast reconstruction are completely covered by insurance. Generally, if a patient’s insurance plan covers the cost of mastectomy for breast cancer, the company is required by law to also pay for the breast reconstruction procedure of the patient’s choice. For those patients that undergo preventative mastectomy, insurance will cover the cost of reconstruction surgery if the patient’s risk of developing breast cancer is considered high enough.

However, patients often wonder if there are any fees that insurance will not cover. Expenses such as deductibles and co-pays generally come out of the patient’s own pocket. So, is there any way to cover the cost of these fees? Patients can open up an FSA, or flexible spending account, with their employers. The money that is put in the FSA is not subject to state and federal taxes. This allows patients to set aside a certain amount of tax-free money each year that can be used to pay for medical costs. 

For breast reconstruction patients, some of the out-of-pocket costs that can be covered by an FSA include:

• Deductibles: Deductibles are due each year. They are paid before the insurance company offers any benefits. Check with your insurance company to see what your plan’s annual deductible is.
• Co-pays: This refers to the fixed amount of money that must be paid when attending a doctor’s visit, undergoing a medical procedure, or getting any other type of medical service. Check with your insurance company to see what your plan’s co-pay is.
• Revision surgeries: Insurance will generally pay for one revision surgery after breast reconstruction surgery. However, further revision surgeries must be paid by the patient.

This does not constitute a full list of fees that may be covered by the patient.

While an FSA can be helpful in paying some of the additional costs associated with breast reconstruction surgery, they do have their limitations.

• Patients can allocate a maximum of $2,500 per year to be put in the FSA.
• The money put into the FSA must be used up in that calendar year, with two possible exceptions; if the employer offers a rollover option, in which $500 from last year can be rolled over to the next year, or a grace period, in which the funds can be used for an extra two-and-a-half months.
• FSA funds can only be used on eligible medical expenses.

To schedule a breast reconstruction consultation, contact Crawford Plastic Surgery.