Question for those with implants.....

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postal2
Veteran Member


Date Joined Jul 2003
Total Posts : 1106
   Posted 4/17/2007 1:09 AM (GMT -7)   
Does anyone here know what happens insurance-wise if and when the implants goes bad? I know when I had my reconstruction (s) my ps told me that they do not last forever, so someday it may have to be replaced. Mine are fine, by the way, I was just thinking about that though. Anyone know if insuarance covers the replacement since they paid for the originals?
Gail
  It's only when we truly know and understand that we have a limited time on earth -- and that we have no way of knowing when our time is up, we will then begin to live each day to the fullest, as if it was the only one we had.
 
Elisabeth Kubler Ross


Frayda
Regular Member


Date Joined Aug 2003
Total Posts : 248
   Posted 4/18/2007 6:12 AM (GMT -7)   
Hi, Gail! I did have to replace an implant, twice! Insurance paid both times.  I think they are obligated because it is related to mastectomy reconstruction.  Dealing with insurance companies as a profession, I know that if they can figure out a way not to pay, they will! You have to know your rights and fight them if they try to weasle out of it. Hope all is well! L&H, Frayda

postal2
Veteran Member


Date Joined Jul 2003
Total Posts : 1106
   Posted 4/20/2007 12:20 AM (GMT -7)   

Hey Frayda!! Good to hear from you! Thank you for the info. Did you have the last replacement long after the first surgery? Just wondering as I had to have it done over once (by original surgeon) and then again because I was not happy with the fact one was noticable higher than the other and the surgeon said he had done all he could. I had an HMO at that time and they asked for pictures and then decided I was good enough mad so would not pay again. I ended up pulling $$$ out of my reitirement fund and went to Seattle were I got all new implants and he fixed the un-eveness (sp? is that a word?lol) Anyway, I sure hope if they ever go t^ts-up, (pun intended tongue  ) that I will be covered. I don't know what I would do.

Hope you are doing really well dear friend!

Gail


  It's only when we truly know and understand that we have a limited time on earth -- and that we have no way of knowing when our time is up, we will then begin to live each day to the fullest, as if it was the only one we had.
 
Elisabeth Kubler Ross


Frayda
Regular Member


Date Joined Aug 2003
Total Posts : 248
   Posted 4/20/2007 6:11 AM (GMT -7)   
I had the first implant replaced about 4 months after the original. Right from the beginning, the right implant had problems: it swelled up twice the size as the left side and took a really long time for the swelling to go down. Then it felt like a rock (compared to the right side). It turned out to be capsular constricture and had to be replaced. My ps said he had never seen that happen so quickly before. He said I had formed a lot of scar tissue around the implant. Maybe my RA had something to do with that (autoimmune response). Then a year and a half later, the same side began leaking (it got noticably smaller) so we replaced it again! That was three years ago, and so far, so good! He said the average life of an implant is 10 years, so replacement must be fairly common and insurance companies have to deal with it. Again, hope all is well!
Frayda

Irish_Mom
Regular Member


Date Joined Apr 2007
Total Posts : 385
   Posted 4/28/2007 12:20 PM (GMT -7)   
I had a redo due to capsular contractures after four years. I had to go to a different PS for this because my original PS didn't take our insurance any longer. I was part of a medical study for silicon implants and just went back to my original PS for the end of the study paperwork. At this appointment, I found out that he takes our new insurance so that was good to know. He asked me what had happened that caused the other surgery to be done. I told him and said that the 'other PS' had fixed whatever needed to be fixed but that she used the same implants again. He then said that they're a one-time use appliance and shouldn't have been put back in again. Grrr! During the exam, he asked if I had noticed that the right side was smaller and I told him that I just thought it had shifted or something. Further testing revealed that it has a small leak, most likely from the other PS putting it back in. I'm scheduled for new implants and a scar revision at the end of May. Insurance has approved everything without a problem.
 
I'm new to this forum...nice to meet all of you.
Breast Cancer at 36. Diagnosed in 2000. Bilateral mastectomy with reconstruction.
Status post partial colectomy, possible colonic inertia with subtotal colectomy in the near future.
Son diagnosed with Crohn's at 17 (now 20). Taking Asacol and 6MP with Prednisone and Rowasa added during flareups.


postal2
Veteran Member


Date Joined Jul 2003
Total Posts : 1106
   Posted 4/29/2007 12:11 AM (GMT -7)   
Irish_Mom, hello! Welcome to the board. Wow, It sounds like you been through alot, and having a child being sick has got to be very hard. Well, you have come to a great place with a great bunch of ladies. Some of us have actually met a few times as a group in person and it was wonderful!
I am from WA State and ladies here are from all over the US. We have some from other countries, also.
Thank you so much for the infomation, that is SO reasuring to know that it is covered even after another PS was involved!
If you feel comfortable we always love to know where people are from. Sometimes it turns out that someone else here is nearby. Well stay with us and I am sure you can help others that are here too!
Again, WELCOME!
Gail
  It's only when we truly know and understand that we have a limited time on earth -- and that we have no way of knowing when our time is up, we will then begin to live each day to the fullest, as if it was the only one we had.
 
Elisabeth Kubler Ross


Irish_Mom
Regular Member


Date Joined Apr 2007
Total Posts : 385
   Posted 5/5/2007 8:30 AM (GMT -7)   
Hi Gail,
 
Thanks for the welcome! You're right in that I've been through a lot...the breast cancer is only part of it. LOL I just try to keep a good sense of humor about things and it helps. I always tell my parents that they need to get a refund. Our son is doing well with the Crohn's at this point. He's in college and so far he only tends to have flareups during finals which is to be expected I guess.
 
We live in Northern California (Central Valley). I'm 45 and have been married to my husband for 26 years. We have two sons (18 and 20). I work at a doctor's office.
 
I also go to another breast cancer forum and a lot of us have met in person too. It's nice to be able to put a face to a name isn't it?
 
My brother lives in Seattle. Beautiful up there!
 
Terri
Breast Cancer at 36. Diagnosed in 2000. Bilateral mastectomy with reconstruction.
Status post partial colectomy, possible colonic inertia with subtotal colectomy in the near future.
Son diagnosed with Crohn's at 17 (now 20). Taking Asacol and 6MP with Prednisone and Rowasa added during flareups.

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