If you are on regular Medicare, that will pay for bilateral mastectomy (80%) I think. I just had one with reconstruction. I do not know how Medicare Advantage plans pay. I think with the emphasis on genetics and targeted therapy we will be finding more genetic mutations for all parts of the body. I have the CHEK2 and people in my family have it. I believe that my genetic test looked for 17 mutations. I do not know if there is a test for just BRCA1 and 2. I also believe that genetic testing should be done with the first BC. That way you have the ability to make informed choices on treatment. If a person has a genetic component, they can opt for mastectomy at the time of the first occurrence. I had DCIS in 2007 and IDC in 2018 and genetic testing in 2019. I had lumpectomies both times. I did not have to dwell on whether or not to take the mastectomy route. I had reconstruction at the same time. Do your research on good doctors, plastic surgeons and choice of reconstruction. I had diep flap and the only thing missing now are the nipples which will be formed and tattooed. I have sensation in the skin of my new breasts, but will not have it in my nipples. You need to find an excellent plastic surgeon or you could have problems. I think it is easier to find the plastic surgeon first and he can possibly hook you up with a surgeon...I think they know surgeons that do good work and know they can have a better outcome.