Will Insurance Cover Your Plastic Surgery?

Wednesday, April 29, 2020, 6:00 PM | Leave Comment

Cosmetic surgery is typically viewed as a superficial treatment that people pay for using their own money, but this isn’t always the case.

While plastic surgery may be elective surgery, in some instances, insurance companies will cover some or all of the costs.

Read on to learn more about whether or not insurance will cover plastic surgery.

Will Insurance Cover Your Plastic Surgery

  • Insurance Companies and Plastic Surgery

    The first question to address when considering approaching your insurance company about covering plastic surgery is to determine if the surgery will be reconstructive, cosmetic, or preserving your quality of life in any way. The answers to this question will affect whether or not your insurance company can cover all or some of the costs of surgery.

    Though every insurance company will have a different approach to covering the costs of plastic surgery, most follow standards set forth by the American Society of Plastic Surgeons and the American Medical Association including the following:

    • Cosmetic Surgery

      Cosmetic surgery refers to any surgery that reshapes the normal structure of the body in order to improve the appearance or self-esteem of an individual. While anyone can voluntarily elect for cosmetic surgery, choosing to do so doesn’t make it medically necessary.

    • Reconstructive Surgery

      Reconstructive surgery refers to surgeries that are performed to correct physical abnormalities caused by congenital defections, trauma, disease, infection, or developmental abnormalities. This type of surgery can improve one’s appearance and quality of life.

  • Understanding Medically Necessary Surgeries

    Medically necessary refers to surgery that an insurance company deems essential to one’s health. While your insurance policy may have a strict definition of what surgeries are medically necessary, the term itself may change based on your specific insurance, how the surgery relates to your needs and the evolution of medical treatments and procedures.

    Most medically-necessary surgeries are those that will eliminate or improve health problems. Surgeries that impact the abdomen, breasts, ears, eyelid, face, hand, and nasal cavities may be deemed as medically necessary. Cosmetic surgery that isn’t likely to be considered medically necessary or covered by insurance includes breast augmentation, liposuction, and eyelid surgery. If you believe a surgery you’re considering should fall into the category of medically necessary surgeries, it’s important to talk to a doctor as they will be able to confirm your condition and share their findings with your insurance company.

  • How to Approach Your Health Insurance Company

    Even if you believe that your surgery isn’t considered medically necessary, your health insurance company may cover the surgery anyway. It’s important to get in contact with your insurance company when considering surgery to determine if they will cover it or not.

    Start by contacting the insurance company or plan administrator directly to determine what coverage there is for the plastic surgery procedure. The next step is to get an estimate to predict the expenses of your plastic procedure and review this against the policy coverage. Determine what the deductible might be should your insurance company choose to cover the procedure and if you’ll be expected to cover a certain percentage out-of-pocket.

    Additionally, make sure to ask about the cost of related medications and if the insurance company will cover these costs. Then, consider whether the insurance company will pay for a portion of the procedure if you pay half of the cosmetic benefits and the insurance company pays for the medical benefits. If your insurance company agrees to pay for any portion of the surgery, be sure to get these details in writing as proof of this agreement.

  • Is Plastic Surgery Right for Me?

    Anyone can choose to get plastic surgery, but not everyone is right for this type of procedure. Similarly, one must be cleared for surgery by a doctor in order to follow through with the procedure. Additionally, while cosmetic and reconstructive surgeries are designed to improve your wellbeing and quality of life, it’s important to have realistic expectations for life after surgery. Be sure to consult with a licensed plastic surgeon and your doctor to learn more about what to expect with plastic surgery.

Before deciding to get plastic surgery, make sure you’ve carefully researched all options for funding the procedure. According to Beyond Beauty, a company that strives to provide the best Miami plastic surgery, one of the most important things you can do when considering plastic surgery is finding a surgeon you trust. As you learn more about whether or not insurance will cover your chosen surgery, keep this guide in mind to help you make your decision.

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