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Health & Family

Does Insurance Cover Plastic Surgery?

There are many questions to answer before deciding to get plastic surgery or not, including those associated with who will pay for the procedure.

Some people may be under the impression that insurance never covers plastic surgery. Conversely, there are those who may assume every medical procedure, regardless of what it may be, is covered by their insurance policy.

Neither way of thinking is 100 percent accurate, though there are some procedures that are not typically covered.

The question of whether insurance covers plastic surgery depends on many factors, including but not limited to:

  • Your particular insurance company
  • Your particular insurance policy
  • The reason for the surgery: cosmetic, reconstructive, or to improve your health

While all of these details should be considered, the third point is the most important.

Reconstructive or Cosmetic?

The majority of insurance companies follow guidelines provided by the American Society of Plastic Surgeons and American Medical Association in regards to what’s reconstructive and what’s cosmetic.

  • Cosmetic surgery is defined as a procedure to a normal body structure to improve the appearance and/or self-esteem of the patient.
  • Reconstructive surgery refers to any procedure on a part of the body damaged by trauma, disease, developmental abnormalities, or congenital defects.

Note: these basic definitions are interpreted by the insurance company to determine if a procedure is covered. The way that one insurer evaluates what is covered may not be identical to another company.

Cosmetic Plastic Surgeries Not Likely to be Covered

Simply put, if you’re opting for a procedure for the sole purpose of improving your appearance, it’s not likely to be covered by your health insurance plan.

Some of the many procedures that have a place on this list include:

  • Eyelid surgery
  • Facelift

woman considering plastic surgery

With the number of cosmetic procedures growing over the past few years, reaching 15.9 million in 2015 (a two percent increase over 2014), it seems there are people who will continue to opt for plastic surgery, even if it’s not covered by insurance.

Note: since there is so much gray area, it’s best to verify your coverage with your insurance company before doing anything.

Cosmetic Procedures Could be Covered by Insurance

In the event that a cosmetic procedure is considered medically necessary, it could be covered by your insurance plan. Here are some common procedures that fit into this category:

  • Also known as reconstructive surgery for the nose, it may be covered for patients with a deviated septum.
  • Breast reduction. If the size of a woman’s breasts is negatively impacting other areas of her body, such as her back and neck, this procedure may be covered.
  • Weight loss surgery. If you’re diagnosed as obese and have failed to lose weight via a medically guided exercise and diet plan, insurance may cover the cost of weight loss surgery..

A Personal Loan Could Be Used to Cover Medical Expenses

If your procedure is covered, you may be able to move forward at a financial obligation you can manage..

For procedures that are not covered, using a personal loan to cover the costs may be a viable alternative. Personal loans can offer quick and easy access to funds at a fixed interest rate.

A personal loan calculator can help you estimate payments depending on how much you need for your medical expenses.