Is areola tattooing covered by insurance after mastectomy?

I understand why this is one of the first things people ask. You have already sat through more appointments and more paperwork than anyone should have to, and this is the last stop. It is fair to want to know whether the last stop can come with a little help. Here is what I know, and where my knowledge ends.

Will my insurance pay for areola restoration?

Some clients have had success getting partial reimbursement for areola restoration after mastectomy through their health insurance. The reason is that federal law requires many plans that cover mastectomy to also cover reconstruction.

I want to be careful with that sentence. Some clients, and partial. Plans differ, and I would be doing you no favors if I promised more than I can know. I have never seen your policy, and I am not the one who decides.

What can you do about insurance, and what can you not?

Here is the plain list.

• I cannot bill your insurance company on your behalf.
• I cannot guarantee any reimbursement.
• Payment for your session is due at the time of your appointment.
• I can give you a standard receipt, and you may choose to submit it to your insurer.

I am not a medical provider. Paramedical tattooing is cosmetic camouflage and restoration work, it comes after your medical team is finished, and it is not medical care.

What should I ask my insurance company before I book?

Call them yourself, before you book. I encourage everyone to do that, because they are the ones who can tell you what they would require. Here are some questions worth asking, and I am not an insurance expert, so take these as questions to ask, with the answers coming from them.

• Does my plan include reconstruction after mastectomy, and does that include the nipple and areola?
• What would you need from me to consider reimbursing a service like this?
• Does a receipt from a provider who is not a medical provider count, and what should it show?
• Do I need anything from my surgeon first?
• Does timing matter?

Ask before you book. It is easier to plan around an answer than to go looking for one once the session is done, and whatever you decide, you decide with the facts in front of you. Write down who you spoke with and what they told you. If a phone call feels like too much on a hard week, ask someone you trust to make it with you.

Does insurance cover scar or stretch mark camouflage?

Cosmetic work such as stretch mark or scar camouflage that is unrelated to mastectomy reconstruction is generally not eligible for reimbursement, so please do not count on insurance for these.

What does areola restoration cost, and what does it include?

Pricing is quoted at your free consult, after we talk, because the answer depends on your skin and on the work itself. Matching one new areola to the side you still have is harder than making two that match each other, so one-sided work is quoted differently. The matching is the job. Color, size, position and the shadow that makes it read as three-dimensional all have to answer to something already on your body.

The touch-up is in the plan from the beginning, and we agree on the whole thing, cost included, before anything begins. Nothing about the total arrives as a surprise while you are lying on the table. You can read how quotes work on the pricing page, and about how the work goes on the areola restoration page.

Can I still book if I am not sure about coverage?

That is your call, and both choices are reasonable. Some people want an answer from their insurer first. Some decide the timing is right for them whatever the reimbursement turns out to be. The consult is free and stays free whether or not you book anything, so you can find out what your own case would cost before you pick up the phone to your insurer. There is no pressure at the end of it.

When can I have it done?

After your reconstruction has fully healed and settled. Your surgeon is the person who tells you when that is, so ask at your next appointment. There is no deadline on this. Twenty years after a mastectomy is not too late, and neither is two. If timing matters to your insurer, ask them, because I cannot speak for your plan.

You are welcome to call me before that day arrives. Plenty of people do, just to know what is ahead. If you want the whole picture of what the session is like, I wrote it down in areola tattoo after mastectomy: what to expect.

If you are the one handling the paperwork

Thank you for doing it. Holding the folder is a lot. A short list helps: the questions above, the name of the person at the insurance company, and the receipt from the session. Whether and when is hers to decide, and the kindest thing you can do is keep the folder tidy if she wants you to.

How do I start?

Text 805-971-0097 when you are ready, and not before. You do not have to send a photo to start, and you do not have to explain anything. We do fifteen minutes on the phone, free, and I tell you honestly where your skin is, what is possible, how many sessions it usually takes and what it would cost. If you are not ready yet, I will say that too, and you can text me again in a year.

Quick answers, including the insurance question, live on the FAQ page, and you can also reach me through the contact page.