Is Plastic Surgery Covered by Health Insurance?

Posted by administration on August 22, 2016

Plastic_Surgery_Health_Insurance.jpgIf you are considering plastic surgery and wondering if your health insurance will pay for the procedure, it's generally easy to find out. Just ask your insurance company whether your procedure is included in your plan—that is, whether they'll cover it and if so, make sure to ask at what percentage they'll cover.

Whether they'll cover a particular surgery or not will often depend on if the surgery is deemed medically necessary or purely cosmetic. Many plastic surgeries are health-related as they help fix and prevent serious health problems, and these are the surgeries most often covered by insurance. Breast reduction for treatment of back pain is one example.

How to Make Sure Your Plastic Surgery is Covered by Health Insurance Before You Schedule a Procedure:

1. Contact your health insurance plan administrator or insurance company directly and find out what coverage you have for plastic surgery procedures.

2. Get an accurate estimate with detailed cost predictions for your plastic surgery procedure so you can review this against your policy coverage.

3. Find out what your deductible would be in the event of coverage.

4. Find out what the maximum amount payable is, and if they expect you to pay a certain percentage of the procedure.

5. Find out what related medications like pain killers would be covered.

6. Get the details in writing of your coverages so you are not surprised. Never assume anything is covered unless your health insurance company confirms it.

Always check with your health insurer before you make any assumptions. What is covered or not is different for not only different insurance companies, but also for different policies within the same company – this is why it so important you check on your particular coverage first. It is also hard to determine what is considered necessary or simply cosmetic. In some cases, only parts of surgeries may be covered, which makes it more complicated. Be prepared before you file your health insurance claim so you are not surprised at what portion they pay on your claim.

If you are interested in plastic surgery and would like to discuss your options with Dr. Serota, contact Advanced Cosmetic Surgery Center in Denver at 303-367-9000 or serotamd.com to schedule a consultation. 

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