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Prophylactic surgery is recommended for some people
Prophylactic or risk-reducing surgery is recommended for certain people at increased risk of cancer due to an inherited genetic mutation. Expert medical guidelines encourage consideration of risk-reducing salpingo-oophorectomy, hysterectomy, mastectomy, etc. for individuals with specific mutations. See the Risk Management Guidelines for guidance as recommendations vary for different hereditary mutations.
Although these surgeries are preventive in nature, they are rarely covered by health insurers at 100%. Deductibles, coinsurance and copays often apply. In some cases, prophylactic surgery may not be covered at all. It is important to understand your insurance benefits before moving forward with risk-reducing surgery so you can plan appropriately for your out-of-pocket costs.
Related Resources
- Checklist: Preparing for oophorectomy surgery
- Checklist: Preparing for hysterectomy surgery
- Brochure: Considering mastectomy? Questions to ask your doctor
- Checklist: Preparing for mastectomy surgery
- See the Reconstruction or Going Flat section of our website for more information about your options following a mastectomy and a photo gallery with different types of breast reconstruction.
Paying For Care
- If your insurance company denies coverage of risk-reducing surgery, visit the Health Insurance Appeals section of our website for guidance and resources.
- Alliance in Reconstructive Surgery (AiRS) Foundation provides grants to offset the costs of breast reconstructive surgery for women in need.
- Federally qualified health centers (also called “Community Health Centers”) are a resource for anyone who needs financial assistance with their health and preventive care.
- Hill-Burton facilities provide free or reduced-cost health services not covered by a government program such as Medicare or Medicaid to those with limited income.
- Medicare Rights Center is a national nonprofit organization that works to ensure access to affordable health care for older adults and people with disabilities under the Medicare program.
- Patient Advocate Foundation provides case managers who help identify financial assistance programs and resources for those facing challenges.
Open Clinical Trials
- Visit the FORCE Research Study Search tool for information on hereditary cancer research studies that may cover certain risk-reducing interventions.