In many cases, yes. A federal law, the Women’s Health and Cancer Rights Act of 1998, says that if your health plan paid for your mastectomy, it must also cover reconstruction and anything that restores symmetry. Areola tattooing is the final stage of reconstruction.
Getting your plan to honor that takes some work. Here is how to do it.
This is reconstruction, not cosmetic
Calling it cosmetic is exactly what lets a plan say no. An areola tattoo restores something cancer took. Krissy is a nurse before she is an artist, and she will make that case with you.
Which plans the law covers
Group and individual health plans: the 1998 law applies.
Medicare and Medicaid: they follow their own rules. Medicare does cover breast reconstruction after mastectomy for breast cancer. Ask your plan specifically about nipple and areola reconstruction.
Some church and government plans also run under different rules. Check which one you have before you call.
Before you call: what to get from your surgeon
Your diagnosis code
The procedure codes from your surgery
These are the first things your plan will ask for. Having them ready saves a round of phone tag.
What to say when you call
Try this: “I want to get this done. I was referred by my plastic surgeon. What do you need from me to have it paid for or reimbursed?”
They will likely say it is not covered. That is the start of the conversation, not the end. Krissy has spent about 20 hours on the phone for a single client, and she will walk you through it.
How payment works at Rise
Rise is an independent studio and does not bill insurance directly.
You get an itemized receipt and the documentation to submit for out-of-network reimbursement.
Your second session is included. A third, if needed, is free.
Touch-ups years later can be submitted for reimbursement too.
Ask about payment plans. Krissy would rather find a way than have cost be the reason someone does not finish this.
Why it is worth the call
Plenty of women just pay and move on, and that is okay. But every claim that gets paid helps hold plans to the law. Krissy would rather your plan cover this than you.
Quick answers
Does insurance cover nipple tattoos after mastectomy?
Many plans must, under the Women’s Health and Cancer Rights Act of 1998. Medicare and Medicaid follow their own rules.
Does Rise Skin Studio bill my insurance?
No. You receive an itemized receipt and documentation to submit for reimbursement.
What codes do I need?
Your diagnosis code and procedure codes, from your surgeon’s office.
Let’s talk it through
Insurance questions are a great reason to reach out. Call or text 605-530-0057, or use the contact form. The FAQ page has more.