Cosmetic Surgery Insurance

For the average middle-class individual, surgery can be an expensive prospect. The latest advances in medical technology and the finest skilled surgeons can do wonders to improve the quality of your life, or save it, but the hospital bill can add up to quite a staggering sum. For therapeutic procedures, medical insurance can significantly offset this concern. However, if the surgery that the patient desires is cosmetic in nature, insurance companies generally do not cover the operation. Does this mean, then, that manufactured beauty is the province only of the wealthy? Not necessarily. Although the truly transformative surgeries may well be out of the reach of the common woman, whether or not an insurance company will finance a rhinoplasty or a breast reduction is dependent on how the surgery will be characterized. It is important to understand the distinction between a cosmetic procedure, which is purely elective and solely for the purpose of making the patient more physically attractive, and a reconstructive procedure, whose purpose it is to restore or improve normal body function or correct a clear disfigurement.

Unfortunately, it is the insurance companies who determine what constitutes an elective cosmetic surgery, versus an operation that is considered therapeutic. By way of example, circumcisions on male infant children used to be covered by insurance. Today, more often than not, an insurance company will not defray the cost of the procedure, as it is now considered elective, and therefore, not necessarily essential. Conversely, certain operations that were once strictly thought of as cosmetic are now being re-evaluated as being necessary for the sustaining and improvement of a person’s health, due to special conditions or difficulties of the patient involved.

An abdominoplasty is typically elective, to make a person’s midsection look more aesthetically pleasing. However, individuals who have lost massive amounts of weight, or have suffered similar circumstances that cause huge folds of skin to droop in the abdominal region, tend to experience various health problems. These include the formation of sores and rashes, hernia, or simply the inability to move and walk normally.

Breast alteration surgeries, also thought of as purely cosmetic, may now be assessed as therapeutic for women with excessively large breasts who have trouble with posture or back problems. Likewise, if a woman has lost a breast or two due to breast cancer and requires breast reconstruction, the insurance companies may be sympathetic to her need to resume a normal appearance.

Facial, ear and nose reconstruction surgery can be covered if the purpose is repair a congenital deformity, or to restore the appearance of a person who has suffered a disfiguring injury. In these instances, although aesthetics is still the primary consideration, the procedure is being conducted to recover a normal look, and not to provide any additional comeliness. For rhinoplasties, sometimes the alteration is made due to difficulties with breathing, so it will likely be covered by an insurance policy. In like manner, surgery performed on drooping eyelids that restrict vision will be considered therapeutic instead of cosmetic.

Before one runs off to the nearest cosmetic surgeon’s clinic, however, one ought to consult first with the insurance company that will potentially provide the coverage for the procedure. The insurance company has final say on whether or not the cosmetic operation one selects is eligible under a patient’s policy, but internal systems of appeal are available to the patient to plead his or her case and explain why it should be covered. A partial coverage may be better than none at all, which some insurance companies will provide by way of a compromise. One’s cosmetic surgeon should be able to provide excellent insurance financing advice and assist in presenting the need for coverage to the insurance company concerned.