Treatment of BIA-ALCL

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare cancer that can develop in the capsule around an implant used in breast reconstruction or augmentation. BIA-ALCL has been linked to textured implants. A small number of cases have been reported in women with smooth implants but these women may have previously had textured breast implants. Important information about BIA-ALCL is posted on the FDA website and professional societies have created patient resources and safety information. 

The majority of health insurers cover breast implant removal and treatment for women diagnosed with BIA-ALCL. It is not recommended that patients with textured implants remove them unless they are experiencing complications. However, in light of recent concerns about potential health risks, some health insurers cover removal (also known as explant) and, if desired, exchange of textured breast implants regardless of complications or illness.

WHRCA does not require 100% coverage by health insurance so copays, coinsurance and deductibles may apply. Coverage and out-of-pocket costs may vary with in-network versus out-of-network providers. Medicaid coverage varies by state. 

Medicare & Medicaid

Medicare and Medicaid are public programs that are not bound by the WHRCA. They have their own rules. Original Medicare Part A and Part B provide benefits that help cover the costs of hospital stays and outpatient services related to many surgeries. Treatment of ALCL and surgery for breast implant removal should qualify as a covered, medically necessary procedures.