Does Medicare cover preventive mastectomies when testing indicates a patient is at risk for developing breast cancer or when the patient has a genetic mutation?

Answer:
No. Medicare does not cover preventive/prophylactic mastectomies performed in the absence of signs or symptoms of breast cancer. However, there may be certain circumstances where a similar surgery is reasonable and necessary (e.g., contralateral mastectomy when diagnosed with breast cancer in the other breast) and those would be considered on a case-by-case basis.

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