A lot of people are afraid of getting plastic surgery because they think that their health insurance won’t cover the costs of the procedure. This is a legitimate fear because plastic surgeries can be quite expensive. However, there are many kinds of plastic surgery operations, even some normally seen as a cosmetic surgery that can be covered by insurance.

What Differences do Insurance Companies Look For?

The key difference is whether your surgery is considered cosmetic or reconstructive according to your insurance company. The core difference is that cosmetic insurance is meant to increase beauty or self-esteem, while reconstructive surgery is meant to correct a fault.

While some plastic surgeons will say they specialize in either form or do both, the real question is how your insurance company defines the two. Every company’s policies are different, so we cannot say for certain about what is covered or how much. But, we can talk about some of the procedures that can fall under reconstructive surgery.

When Can I Get Insurance Coverage for Plastic Surgery?

First, if a disease causes your physical abnormality or injury and plastic surgery can help, then it’s likely to be covered. You might need nose surgery to correct a breathing problem, hand surgery to fix carpal tunnel or a tendon injury, or facial surgery to correct the drooping due to paralysis. It may surprise you to know that skin graft surgery for burn victims is often done by a plastic surgeon.

Sometimes a reconstruction surgery is just a more intense version of a cosmetic procedure. Some women are born with breasts so large that it makes it very hard to walk. In these cases, breast surgery is necessary to correct the problem. Eyelids might droop so far that they obstruct vision and an eye lift might be needed to correct it.

What Procedures Usually Aren’t Covered?

Common cosmetic procedures that aren’t covered include liposuction, breast implants, and most other eyelid surgeries. However, there are rare cases of coverage. For instance, if you are morbidly obese and it’s affecting your mental health, an insurer may cover the costs of a tummy tuck. However, this is normally done after a long evaluation and psychiatric examinations.

Find Out if You Have Coverage

Since what is covered can vary widely, once you get a diagnosis, it’s time to talk with your insurance provider. You should do this yourself before setting a surgery date. Ask the following questions:

  • Do they cover plastic surgery procedures at all?
  • What do they predict that your surgery will cost? Be sure to include things like painkillers and follow-up visits.
  • Find out your deductible, your lifetime payment limit, and how much you might be responsible for paying for the whole procedure.
  • You can ask what evidence they want to qualify you for reconstructive coverage (e.g. photographs, other attempts to fix the problem.)
  • Ask if they have guidelines for the surgery for qualification (e.g. so many grams of tissue must be removed.)

How To Reduce Costs

If the cost is too much, your doctor may be able to help by talking with your insurance company. Sometimes a procedure can be considered both cosmetic and reconstructive and the costs split along those lines, or lodge an appeal on your behalf. It is crucial that you clear all of this first so that you don’t replace your current physical issues with financial ones.

Contact The Letter Center today to find out if your skin procedure can be covered by your insurance provider.