Plastic surgery can be an expensive procedure, and many patients wonder how much of the cost their health insurance will cover. The answer is different for each patient, depending on their procedure and type of coverage. But there are some general rules to keep in mind when asking your insurance company about plastic surgery.
Insurance companies classify plastic surgery procedures into two main types, based on definitions provided by the AMA (American Medical Association) and ASPS (American Society of Plastic Surgeons):
Reconstructive surgery corrects an abnormal bodily structure to restore normal function. It includes procedures that address congenital defects, developmental abnormalities, disease including infection and tumors, and trauma.
Cosmetic surgery modifies normal bodily structures for aesthetic reasons.
Generally, reconstructive surgery is considered a medical necessity, and insurance companies will help cover the cost. On the other hand, cosmetic surgery is considered a personal choice which most insurance will not cover.
The boundary between reconstructive and cosmetic surgery can be blurry. For example, circumcision was once considered reconstructive surgery, but due to scientific studies and evolving cultural norms, many insurance companies now consider it cosmetic and do not pay for the procedure. Procedures like breast augmentation and liposuction are considered cosmetic and not typically covered by insurance. Many procedures, though, can be either. Here are some examples of procedures that may fall under the definition of reconstructive surgery and receive some coverage:
And many more. Every insurance company operates differently.
Before you commit to a plastic surgery procedure, we highly recommend that you contact your insurance company first to determine your coverage. We can provide you with a detailed cost estimate to compare to your policy coverage. Some details to watch out for:
In some cases, your insurance may be willing to pay for part of the procedure, while you cover the portion that is considered cosmetic. Always get the details in writing so you have concrete facts to guide your decision.
Contact Beverly Hills Plastic Surgery Group with any questions regarding insurance coverage. We will do our best to keep you informed and guide you through the process of interacting with your insurance company.