Is Plastic Surgery Covered by Insurance?

Is Plastic Surgery

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When it comes to plastic surgery, most insurance policies will not cover the cost. This is because it is typically deemed as elective and not medically necessary. However, plastic surgery that is required for reconstructive purposes may be covered.

When is Plastic Surgery Covered?

If you have certain medical issues that require a plastic surgery procedure, you may be able to get the cost reimbursed to you. It is important to discuss this with your insurance provider because unless you are certain that you are covered, you could end up with a hefty bill.

Let’s imagine you are unhappy with your nose – you don’t like the look of it because it is too big or an odd shape and you would love to have a nose job to change your appearance. It would be very unlikely that your insurance company would pay towards the cost of rhinoplasty surgery because it is affecting your self-esteem. However, if the primary reason for rhinoplasty is a medical one (such as breathing problems or trouble sleeping), then you may be able to benefit from insurance cover.

Another example is breast enlargement surgery. If the main reason for the surgery is to improve your appearance, you can be pretty sure that your insurance company is not going to cover the cost of the procedure. However, if you were having the treatment to rebuild the breast after a mastectomy, then this would be classed as medically necessary and, in all likelihood, would be covered by your policy.

Whether or not you are covered will depend on your insurance provider. You will need to provide medical evidence that the plastic surgery you need is necessary. This might mean having full documentation of the condition you are suffering with as well as records of visits to any medical facility relating to your condition.

If you can get a written statement from your doctor explaining that you have tried all non-surgical options and that the proposed treatment is a last resort, you may be able to persuade your provider to reimburse you for the costs.

What Reconstructive Treatments are Covered?

As mentioned, medically necessary breast reconstruction and rhinoplasty may be covered if you can provide the evidence to back up your claim. There are other reconstructive procedures that are typically covered by healthcare insurance. These are surgeries that are used to treat congenital defects or those caused by tumors, disease, trauma, or infection.

If the treatment you need is covered by your insurance policy, you will need to know the correct medical billing code required to make a claim. You can quickly find it on websites such as Find-A-Code.com (visit their website clicking on this link). All you need to do is search for the treatment you have had and jot down the code. This will make it much easier to fill out your form.

Is Cosmetic Surgery Expensive?

Unfortunately, cosmetic procedures are rarely covered, so you will need to pay for elective treatments yourself. Plastic surgery can be very expensive and unless you have savings to cover the cost, you may need to take out a plastic surgery loan. There are many different options, and it is a good idea to shop around to get the best rates.

An alternative option is to find a plastic surgeon that offers a payment plan. Many will provide a zero or low interest repayment plan that will allow you to split the cost of the procedure over a number of months. Many surgeons will entrust this aspect of their business to a third-party company as it allows them to get the full payment upfront.

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