Unfortunately, most elective cosmetic surgeries are not covered by insurance. However, if there may be functional or health reasons for your procedure, you may be able to have your insurance company cover a portion of the cost according to the guidelines specific to your policy. you may be able to have your insurance company pick up a portion of the cost. In some cases, procedures are considered both elective and medically necessary. It is usually up to your insurance company to decide what portion to contribute based on your physician’s assessment of your condition.
For example, if blepharoplasty (eyelid surgery) is recommended because of eyelid sagging that is impairing your vision, it may be considered functional as well as cosmetic.
Here are some examples of cosmetic surgeries that may be covered by insurance:
· Breast reduction (reduction mammoplasty) to alleviate back problems, shoulder pain, neck discomfort, etc.
· Breast surgery (augmentation mammoplasty) to correct congenital asymmetry.
· Breast reconstruction following mastectomy (breast removal due to breast cancer).
· Male breast reduction (gynecomastia) surgery to combat the condition. Although this is becoming less likely.
· Ear surgery (otoplasty) to correct congenital defects (occasionally covered for severe conditions).
· Eyelid surgery (blepharoplasty/ptosis repair) to correct dropping of eyelids obstructing vision.
· Facial surgery to treat traumatic deformity, facial paralysis, or muscular defects.
· Nose surgery (rhinoplasty) to correct congenital deformity or diseased tissue or improve breathing.
In general, reconstructive procedures performed to combat disease, deformities, traumatic injury, or infection are more likely to be covered than purely cosmetic procedures that are performed only for aesthetic enhancement. However, various insurance companies may interpret “cosmetic” or “reconstructive” very differently. The procedures do not have to be 100% necessary to be covered in some respect by your insurance company. You should make sure to choose a cosmetic surgery center that offers ample financial support.
If you desire cosmetic enhancement, but are concerned about the costs, meet with an experienced cosmetic surgeon to discuss your options. While some plastic surgery centers are more concerned with getting your business than how you are able to afford your procedure, high quality physicians like Chicago/Arlington Heights surgeon Dr. Otto J. Placik and affordable financing to ensure you are able to have the procedure you need.
It is important that you understand the guidelines set forth by your insurance company, In some instances, it may be required for you to undergo a physical examination and photographs. This information is necessary to prepare a letter of predetermination of benefits in order the ascertain the level of coverage under an insurance plan.
