The 411 on health insurance and plastic surgery.

health insurance - plastic surgeryhealth insurance - plastic surgery
health insurance - plastic surgeryhealth insurance - plastic surgery


The 411 on health insurance and plastic surgery

There are some people in the world who are friendly with the idea of changing their looks a little. And then there are people who have no choice but to go under the knife to restore their looks.

But when it comes to plastic surgery, which both types of people know is not the cheapest of medical procedures, how does health insurance help with that cost, if at all?


Types of plastic surgery

The main determinant of whether you’ll be covered or not is based on the type of plastic surgery you will be undergoing. Very much related to the two types of people mentioned earlier.

  • Reconstructive: Reconstructive surgery involves operating to better a birth, or medical defect in order to improve the patient’s ability to live or achieve a “normal” appearance. Generally, the circumstances that lead to reconstructive surgery are necessary for the patient’s well being and sometimes even their survival.
  • Cosmetic: Cosmetic surgery, on the other hand, is purely by choice to make changes to your body for personal appearance preference. So, basically, taking perfectly “normal” structures and rearranging them because you aren’t a fan of them.


Different with every insurance company

The first reality is that every insurance company will have their own policies and coverage options. There’s a chance they might cover you for a certain recreational procedure, but your premiums may be through the roof.

It also depends on the type of health insurance you have and what is considered as cosmetic plastic surgery. Changes in medical treatment, procedures and patient needs also play a role in what is covered and what isn’t.

Insurance companies also have the authority to define and understand the above definition of cosmetic surgery however they would like and that will also affect whether or not you’d benefit.


The quality of life argument

Health insurance companies will have their policies and coverage options set in stone (until such a time as medical advancements change the name of the game). But surgeons are faced with an ethical dilemma of letting a patient pay for a cosmetic surgery that has a personal effect on their quality of life.

A mole, for example, that has been diagnosed as not cancerous but merely a physical nuisance, would have to be paid for out-of-pocket to be removed. Is that fair? Or should the doctor remove it and have it sent for official testing so that it can be claimed under the patient’s health insurance? Is that right? “Suspicious” moles have been known to be covered by insurance.

A person’s quality of life is not lost on health insurance companies and you might find a company that is willing to help you out. It may require some photographic evidence and proof that more conservative measures have been taken in an attempt to relieve discomfort from daily life, but it will be worth it if it means you can get the surgery.


Common procedures covered by health insurance

With all of that said there are still a few things you can “get away with”. Here are some surgeries that majority of health insurance companies would cover you for:

  • Otoplasty (ears)
  • Blepharoplasty (eyelid)
  • Rhinoplasty (nose)
  • Circumstantial breast augmentation (in the context of breast cancer, mastectomy and symmetry)
  • Breast reduction
  • Panniculectomy (removal excess skin after excessive weight loss)
  • Bunion removal
  • Varicose veins

As for the rest – breast augmentation for just wanting larger breasts – that will have to come out of your own pocket.


Cosmetic surgery finance solutions

If you’re still really adamant that this surgery is a necessity for you, then there are other financial options that you can consider.

  • Credit card: Credit cards are there for a reason, right? To give you what you want now so that you can pay it off later, earn credit or something like that.
  • Medical credit card: Then there’s such a thing as a medical credit card that specifically covers medical expenses. These generally come with reasonable rates and will most definitely be able to get you the surgery you want. But, as with any credit card, be sure to make your payments on time and keep tabs on your debt, credit cards for credit card debt is not a cycle you want to fall into.
  • Loans: Personal loans, bank loans, home equity loans and loans from friends and family are all options as well when it comes to finding the cash for a nip, lift, tuck or implant here and there. Just keep an eye out for the interest rates.
  • Payment plans: Some doctors might take the liberty of drawing up a payment plan for their patients and missed payments may not have an effect on your credit score but they can lead to tension in the doctor-payment relationship and possible visits from collection agencies.
health insurance - plastic surgery