According to the American Society of Plastic Surgeons, approximately 6 million Americans undergo plastic surgery in year. That comes out to a lot of money in doctor fees, so who is paying for plastic surgery costs? Well, that depends entirely on your insurance company.
Typically in order for an insurance company to cover a plastic surgery, the surgery needs to be deemed medically necessary. Reconstructive surgery is considered medically necessary by many insurance companies. For example, breast reconstruction after a mastectomy. Nasal surgery performed with a diagnosis of deviated septum is considered medically necessary and normally some cosmetic repair is performed at the same time. A breast reduction may also be covered in cases where the patient experiences moderate to severe chronic pain as a result of having very large breasts. In addition, some reconstruction of cosmetic defects following an accident may be covered under certain plans, and repair of certain birth defects, such as cleft palate, are often covered as well.
Cosmetic surgery is the reshaping of normal structures on the body to improve the self-esteem or appearance of a patient. Take for example, the procedure of circumcision on infant boys. In the past all insurance companies paid for this procedure, but it is now becoming more common that insurance companies will not pay for the procedure because is considered cosmetic. What is considered cosmetic is entirely up to what insurance company holds your policy. What is typically not medically necessary is breast implants (no previous mastectomy), face lifts, liposuction, surgery to remove excess skin around the abdomen, etc.
Plan provisions vary widely. Even one insurance carrier can have 20 different plans available, each with variances regarding covered/non covered services. It is always best to contact your insurance company directly.
