Insurance Coverage
When it comes to plastic surgery or cosmetic surgery, understanding your insurance coverage is vital because you need to stay informed regarding the cost of your health care. There are a lot of things that you need to talk about when it comes to your plastic surgery or cosmetic surgery, including what insurance coverage you have and what your insurance coverage will actually cover in terms of medical costs. There are two different types of plastic surgery, and the insurance coverage for each will be unique. Reconstructive surgery is performed on any abnormal body structure caused by trauma, tumors, developmental abnormalities, disease and congenital defects to improve the function of the body or to create a more normal appearance. Cosmetic surgery on the other hand is designed to reshape a normal structure of the body, improving the self esteem and the physical appearance of the patient.
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What does Insurance Coverage cover?
Your insurance coverage policy is essentially an agreement that exists between you and your insurance provider. An agreement made on services and their fees between you and your cosmetic plastic surgeon is a completely different agreement. When you have cosmetic surgery or plastic surgery, you are who is responsible for paying the doctor’s agreed upon fees. Insurance coverage for these services is going to depend on the contract terms between you and your insurance provider. If your insurance coverage plan does not cover certain parts of the medical costs, then you are responsible for them. Most health insurance policies cover most reconstructive surgeries, although coverage for different procedures and different levels of coverage will likely vary. Cosmetic surgery procedures on the other hand are not typically covered by health insurance plans because these operations are considered to be elective in nature. Cosmetic surgery, on the other hand, is a choice that you make rather than considered to be a medical necessity.
Gray Areas in Insurance Coverage
There are some gray areas when it comes to insurance coverage for plastic surgery, meaning that sometimes special consideration will be required by your insurance carrier. These areas typically involve surgical operations that are capable of being both reconstructive as well as cosmetic in nature, depending on the situation for each patient. For example, eyelid surgery, which is known as blepharoplasty is a procedure that is typically conducted for cosmetic purposes, but it may be covered by your insurance coverage if your eyelids are dropping to the point where your vision is obscured or obstructed. Nose surgery, known as rhinoplasty or septoplasty is typically considered to be cosmetic, except for when it will correct a defect that is capable of causing difficulties breathing.
When your intention is to get surgery of any type, it is important for you to speak with your plastic surgeon and a representative from your insurance company to determine what level of insurance coverage is possible before you undergo the operation, otherwise you may be stuck with medical bills you were not expecting.
