Does health insurance cover plastic surgery?

by Guest » Wed Sep 21, 2011 11:51 am
Guest

My fiancée recently had a car accident and damaged her nose badly along with other facial damages. She has an individual health insurance, will it cover for the plastic surgery she’s planning to go for? Thanks.

Total Comments: 8

Posted: Wed Sep 21, 2011 12:25 pm Post Subject:

Depends on whether or not it’s recommended by a doctor.
An insurance company generally covers a plastic surgery only when it’s deemed medically necessary.
In your case, your fiancé might be covered as she’ll probably go for a re-constructive plastic surgery due to accident, which is usually covered.
But yet to be on the safer side, do consult the physician and get relevant documents to prove the surgery is medically needed.

Posted: Thu Sep 22, 2011 05:38 am Post Subject:

Are cosmetic plastic surgeries also covered by medical insurance? Please give information!

Posted: Thu Sep 22, 2011 05:54 am Post Subject:

Sorry, but typically, Cosmetic surgeries and all other elective surgeries are NOT covered under Medical Insurance policies.

Posted: Fri Sep 23, 2011 06:00 am Post Subject:

Richard & Daisy,

Elective Cosmetic Surgery is NOT covered by health insurance.

Corrective Cosmetic Surgery is covered, but you'll need to get "Prior Authorization" from the insurance company before the surgery takes place. The doctor should be able to get this authorization done for you.

Posted: Fri Sep 23, 2011 09:31 am Post Subject: Does health insurance cover plastic surgery?

Hi,

Answer of this question is sometimes yes, but more often, no. Insurance will cover the cost of some procedures if they are considered reconstructive (as opposed to purely cosmetic) in nature.

Moreover, the surgical correction of any cosmetic defect which significantly impacts function of the body part in question may also be covered.

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Posted: Sun Oct 02, 2011 10:06 pm Post Subject:

I actually had a relative who went through this - if the surgery is for something say like a birthmark that could cause a health problem later - then it should be covered with consent from your physician, but otherwise it's considered Cosmetic surgery which is not covered.
Your situation is specifically corrective cosmetic surgery - an accident definitely isn't something of choice - and any reasonable physician should give you the authorization to have this covered.

Posted: Wed Apr 25, 2012 06:47 am Post Subject:

It will certainly be covered since there's a medical reason for the surgery. Only surgeries that are purely aesthetic in nature are not covered by insurance providers.

Posted: Wed Apr 25, 2012 07:20 pm Post Subject:

There was nothing in the original post, now 18 months old, that mentioned medical necessity. Cosmetic surgery will only be covered by health insurance if it is MEDICALLY NECESSARY. Simple disfigurement, while potentially very unpleasant, is not, by itself, the basis of medical necessity.

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