Plastic surgery is not something anyone would believe medical insurance would cover. In addition, if done for purely cosmetic reasons, this is the case. However, when those procedures are done primarily for health reasons, then your insurance might cover it.
Namely, if the procedure is medically necessary but affects your physical appearance, it may fall under your insurance plan. You will have to make a compelling case in order to justify the medical need and present the ways this surgical intervention will improve the quality of your life. Of course, this all also depends on the medical insurance company and how yours defines the term “medically necessary”.
Some companies recognize the difference between the reconstructive and cosmetic surgery defined by the American Medical Association (AMA). Based on AMA, reconstructive surgery is used to improve person’s appearance or normalize it, referring to birth defects and trauma. On the other hand, cosmetic surgery is changing the shape of the normal forms only to improve esthetical appearance.
If you think to undergo a plastic surgery, here are some procedures your insurance may cover.
Rhinoplasty or popularly known as the nose job is the procedure that many women think they need purely for appearances. However, this procedure can also be medically necessary if the patient has structural defects like a deviated septum. In the end, the insurance may cover only the structural part of the surgery and not the aesthetic one. Even this is good news since the whole procedure is not cheap and covering only the part of expenses can be helpful.
Ears never stop growing and otoplasty or ear surgery can improve their size and shape to make them more proportional. Ear defects present at birth or misshapen structure due to an injury are something otoplasty can easily correct. However, waiting to adulthood can mean that you will completely cover the expenses. If the defect damages the hearing, then it may be covered by the insurance.
Wrinkles around the eyes and sagging skin are one of the first things people tend to notice. They make us look tired and older than we really are. This is the reason why many decide to undergo eyelid lift surgery. The procedure known as blepharoplasty is done on one or both lids by removing the excess skin and achieving a firmer look. Even though this is a cosmetic procedure, there are two instances when the insurance will cover it: if the extra skin blocks the vision and if the upper lid muscle sags over the eye. You should talk to the best surgeon specialised in facial plastic surgery and check your options.
Breast augmentation is one of the most popular procedures and probably many are wondering if it’s covered by insurance. The answer is – no. Of course, you’re looking for the best procedure and you should
Nevertheless, just like in other procedures, there might be cases when your insurance would cover the costs. If you need reconstructive surgery due to the disability or deformity, you may be covered by insurance. Based on the law, insurance companies have to cover breast reconstruction in case of mastectomy.
Breast reduction is also something that your insurance will cover if you feel physical discomfort. Large breasts can cause back, neck and shoulder problems, and most notably constant pain. This includes both men and women since breast reduction in male patients is also a common surgery. In the end, the insurance coverage depends on the surgeon’s opinion and patient’s symptoms.
Excess skin removal
Also known as panniculectomy, the excess skin removal is a procedure that is required for the tremendous weight loss. The excess skin is prone to infections, can cause pain, limits physical activity and mobility. If it’s done to remove the physical discomfort, then your insurance will most likely cover it. Obesity is considered a disease and excess skin appears after the successful treatment, so based on the law, insurance companies have to cover the panniculectomy.
All in all
Tummy tuck, bunion procedure, varicose veins treatment and mole removal are also the procedures your insurance may cover if it includes medical necessity. In the end, it’s important to examine the complete insurance offer and choose the one most appropriate for your needs, health and finances.