When plastic surgery can be covered by insurance

Unfortunately, most elective cosmetic procedures are not covered by insurance. However, if there are functional or health reasons for your procedure, you may be able to get your insurance company to cover some of the costs according to guidelines specific to your policy. your insurance company may pick up some of the cost. In some cases, procedures are considered both elective and medically necessary. It’s usually up to your insurance company to decide what portion to contribute based on your doctor’s assessment of your condition.

For example, if blepharoplasty (blepharoplasty) is recommended because of eyelid sagging that is interfering with your vision, it can be considered both functional and cosmetic.

Here are some examples of cosmetic procedures that may be covered by insurance:

Breast reduction (reduction mammoplasty) to relieve back pain, shoulder pain, neck pain, etc.

Breast surgery (augmentation mammoplasty) to correct congenital asymmetry.

· Breast reconstruction after mastectomy (breast removal for breast cancer).

Breast reduction (gynaecomastia) in men to combat the condition. Although this is becoming less and less likely.

· Ear surgery (otoplasty) to correct congenital abnormalities (sometimes covered for serious conditions).

· Blepharoplasty (blepharoplasty/ptosis repair) to correct droopy eyelids that impede vision.

Facial surgery to treat traumatic deformities, facial paralysis, or muscle defects.

Rhinoplasty (nose surgery) to correct congenital abnormalities or diseased tissue or improve breathing.

In general, reconstructive procedures performed to combat disease, deformity, traumatic injury or infection are more likely to be covered than purely cosmetic procedures performed for aesthetic enhancement only. However, different insurance companies may interpret “cosmetic” or “reconstructive” very differently. The procedures do not have to be 100% necessary to be covered in any way by your insurance company. You must ensure that you choose a cosmetic surgery center that offers adequate financial support.

If you want cosmetic enhancement but are concerned about the cost, make an appointment with an experienced cosmetic surgeon to discuss your options. While some plastic surgery centers are more concerned with getting you business than how you can pay for your procedure, high-quality doctors like Chicago/Arlington Heights surgeon Dr. Otto J. Placik and affordable financing ensure you can have the procedure you need.

It is important that you understand the guidelines of your insurance company. In some cases, you may need to have a physical exam and X-rays. This information is needed to prepare a letter prescribing benefits to establish the coverage level of an insurance plan.