Crushing cost of surgery
New York Post, May 16, 2013

Dr. Copeland comments on the problems of insurance coverage for the type of breast surgery Angelina Jolie underwent.

The preventative double mastectomy that Angelina Jolie underwent may save lives, but the operation is so expensive, many women can’t afford it.


The procedure, which slashed the Oscar-winning actress’ chance of getting cancer from 87 percent to 5 percent, costs more than $50,000 — and health insurance plans often don’t cover it.


“Not all insurance companies at the present time recognize this as a medical necessity,” said Upper East Side surgeon Dr. Michelle Copeland. “When it’s elective in that sense, it’s up for grabs.”


Just the test to determine if a woman has the genes that increase breast-cancer risk costs $4,000. Then there’s hospital fees, surgery and reconstruction costs.


“The problem is not only the surgical fee but the hospital fee — we’re talking about an enormous expense,” said Copeland. “It could cost $50,000 and upward.”


The cost can double or triple if there are surgical complications, other physicians said.


Jolie revealed earlier this week that she underwent a preventative double mastectomy earlier this year, after learning she had marker genes that made her chance of getting breast cancer nearly 90 percent. She got tested for the genes because her mom had breast cancer and died of ovarian cancer.


“I decided to be proactive and to minimize the risk as much as I could,” wrote Jolie, who has six kids, including three adopted, with her movie-star partner Brad Pitt.


While the expense wasn’t much for a Hollywood superstar, average women can face financial woes even if they are insured for the costs of the screening and surgery. Women can often get a runaround from insurers over the cost of reconstruction because some carriers don’t tell patients they’re eligible for it, doctors said.


By law, any insurer that covers a mastectomy, preventative or not, must also cover reconstruction.

New provisions of the Affordable Care Act that go into effect next year will require insurers to cover the costs of the genetic test for breast-cancer risk, but they don’t mandate that surgery costs be covered.


Meanwhile yesterday, Jolie’s surgeon, Dr. Kristi Funk, discussed the details of the procedure in a blog post on the Pink Lotus Breast Center’s Web site. She praised Jolie’s upbeat approach.


“On day four after her mastectomies, I was pleased to find her not only in good spirits with bountiful energy, but with two walls in her house covered with freshly assembled storyboards for the next project she is directing,” Funk said.

“All the while she spoke, six drains dangled from her chest, three on each side, fastened to an elastic belt around her waist.”


Pitt, too, marveled at her attitude — noting that Jolie kept commitments to visit the Congo and London just weeks after major surgery.

It was, he told USA Today, “An emotional and beautifully inspiring few months . . . It’s such a wonderful relief to come through this and not have a specter hanging over our heads.”