August 21, 2018

Do Any Health Insurance Plans Cover Plastic Surgery?

If you are considering a plastic surgery, you may be wondering whether there is a health insurance plan out there that can cover it. The good news is that a procedure that is considered a medical necessity may be paid for by a health insurance plan even if it also enhances your physical appearance.

plastic surgery on female



For instance, your doctor may recommend a breast reduction in order to treat your back pain. As long as you can make an argument for why a certain procedure is a medical necessity and can improve your overall quality of life, you may have a chance in insurance covering it.

Some insurance providers or plans will consider whether a certain condition negatively affects a patient’s daily life. They will look at whether the physical issue interferes with their ability to complete everyday tasks such as taking a shower or working out. Sometimes, a condition will be viewed as more of an inconvenience and not covered.

Insurance companies may also cover the costs of reconstructive surgery i.e. surgeries performed to correct abnormal structures caused by congenital defects, tumour, trauma,  infections etc. Even though these surgeries might seem cosmetic, these enhance the self-esteem and morale of the patient and hence are liable to be considered for insurance coverage.

If you have a mole on your skin which mars your beauty and you are thinking of removing it, there is a chance of having it covered by insurance. Even if the mole is turns out to be benign, insurance can cover it it if it strikes a doctor as suspicious, has a large size or which bleeds and itches.

In the event an insurance company does cover your plastic surgery, you may have to provide them with photographs to prove that your condition is as debilitating as you and a doctor claim. Your insurance company may also ask you what other treatments you have tried. If you have not tried any conservative treatments, they may deny coverage until you do so. Insurance companies only cover plastic surgery if it is a last resort.

For instance, insurance companies might also consider the man boobs reducing surgery provided the patient provides proof that he has tried to decrease his breast size through exercise and diet but has failed and that his gynecomastia is severe and debilitating.

If you’re wondering whether your health insurance plan covers plastic surgery or are unsure of whether your procedure is cosmetic or a medical necessity, contact the health insurance experts at The MAIR Agency today.
(Contributed by Kendall)

Image ccredits: Victor Habbick  via freedigitalphotos.net


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