What Cosmetic Surgery Does Insurance Cover?

As an expert in the field of plastic surgery, I'm often asked about what cosmetic procedures are covered by insurance. The answer is not always straightforward, as it depends on the individual's circumstances and the type of procedure they are seeking. When it comes to breast augmentation, also known as breast surgery, insurance coverage may be available under certain conditions. Generally speaking, insurance companies will consider a procedure to be reconstructive if it is necessary to correct a deformity or abnormality caused by an illness or injury. On the other hand, procedures that are purely aesthetic in nature are not usually covered. For example, if a woman has had a mastectomy and needs reconstructive surgery to restore her breasts, insurance may cover the cost of the procedure. However, if she wishes to have her breasts augmented for purely aesthetic reasons, she will likely have to pay for the procedure out of pocket. In some cases, insurance may cover breast implant revision surgery or the removal of defective implants. Additionally, breast reduction surgery may be covered if it is necessary to alleviate discomfort caused by large breasts. Insurance companies often use cup size as a guideline when determining coverage for breast reduction surgery. In addition to breast surgery, insurance may also cover panniculectomy and abdominoplasty (tummy tuck) procedures. Panniculectomy is a surgical procedure that removes excess skin and fat from the abdomen, while abdominoplasty involves removing excess skin and fat from the abdomen and tightening the fascia above the abdominal muscles. Insurance companies are more likely to cover these procedures if they are deemed medically necessary. When considering any type of cosmetic surgery, it is important to read your insurance plan carefully and work closely with customer service representatives to determine if your desired procedure will be covered. Additionally, it is important to document any symptoms you are experiencing and any non-surgical measures you have taken to alleviate them. This can help demonstrate that your desire for surgery is not frivolous. Ultimately, it is important to remember that insurance companies do not typically cover cosmetic surgeries that are purely aesthetic in nature. However, there are certain circumstances in which they may cover reconstructive procedures or those deemed medically necessary. It is important to research your options carefully before making any decisions.