Questions regarding insurance coverage for cosmetic surgical procedures are very commonly asked. Unfortunately, as there are different insurance companies, different insurance policies, and so many variables involved, there is no one definite answer to these questions. The way to find out for certain whether your cosmetic surgical procedure will be covered by your insurance policy will be to contact your insurance provider directly and ask them. Of course, you will also need to make sure that your cosmetic surgeon works with your insurance carrier as well.
While there are no definite answers, generally, as far as insurance coverage on cosmetic surgical procedures is concerned, procedures that have a medical necessity are often covered by insurance. For example, removal and treatment of skin cancers or precancerous tissue is often considered a medical treatment and covered by insurance, even one performed by a cosmetic surgeon (though not in all cases - again, you must consult with your individual insurance provider to determine this for sure). With treatments for spider and varicose veins, again, the medical necessity of the treatment often plays a major role in the determination of insurance coverage. Cosmetic removal of spider veins is often considered a cosmetic procedure and not covered by insurance, while medically necessary treatment of varicose veins in many cases is covered.
Other treatments, like reconstructive breast surgeries related to breast cancer, may also be discovered to be covered by insurance upon contacting your policy provider.
If your surgery or treatment is medically necessary, or if you and your doctor have determined there is very reasonable medical cause for you to receive that treatment or procedure, you may wish to provide documentation along these lines to your insurance company prior to asking these questions. Being prepared in advance may present you with an upper hand in justifying why your treatment or procedure should be covered by the insurance, especially in the event that it is deemed necessary by your doctor.
Initially, you may want to ask your cosmetic surgeon during your consultation whether he or she has had any prior experience with your insurance carrier and or policy type, in which case they may already have a good idea of the answer you will receive, as well as potential suggestions for how you may be able to get your procedure covered or alternative insurance options that may allow you to receive some sort of secondary coverage toward your procedure or procedures.
In some cases, certain healthcare insurance providers may not directly cover a procedure, but will provide reimbursement after it is completed. This has become common with certain health insurance carriers and simply requires you to prepare and submit paperwork to them after receiving your procedure, as opposed to this being handled directly between your doctor's office and the insurance company.
Again, these are questions for your doctor and insurance company, firstly to inquire whether your doctor is within your health insurance carrier’s network or otherwise able to work with your insurance company, and secondly, whether your actual insurance company itself will cover (or reimburse) the individual treatment or procedure.
If you are considering a cosmetic surgery or other procedure and wondering whether or not it will be covered by your insurance, hopefully this information has been helpful. Many cosmetic surgeons also offer financing options for patients unable to receive insurance coverage or reimbursement for their procedures. You may wish to ask your cosmetic surgeon your cosmetic surgery insurance coverage and financing questions to see if any of these options may be available to you.
While there are no definite answers, generally, as far as insurance coverage on cosmetic surgical procedures is concerned, procedures that have a medical necessity are often covered by insurance. For example, removal and treatment of skin cancers or precancerous tissue is often considered a medical treatment and covered by insurance, even one performed by a cosmetic surgeon (though not in all cases - again, you must consult with your individual insurance provider to determine this for sure). With treatments for spider and varicose veins, again, the medical necessity of the treatment often plays a major role in the determination of insurance coverage. Cosmetic removal of spider veins is often considered a cosmetic procedure and not covered by insurance, while medically necessary treatment of varicose veins in many cases is covered.
Other treatments, like reconstructive breast surgeries related to breast cancer, may also be discovered to be covered by insurance upon contacting your policy provider.
If your surgery or treatment is medically necessary, or if you and your doctor have determined there is very reasonable medical cause for you to receive that treatment or procedure, you may wish to provide documentation along these lines to your insurance company prior to asking these questions. Being prepared in advance may present you with an upper hand in justifying why your treatment or procedure should be covered by the insurance, especially in the event that it is deemed necessary by your doctor.
Initially, you may want to ask your cosmetic surgeon during your consultation whether he or she has had any prior experience with your insurance carrier and or policy type, in which case they may already have a good idea of the answer you will receive, as well as potential suggestions for how you may be able to get your procedure covered or alternative insurance options that may allow you to receive some sort of secondary coverage toward your procedure or procedures.
In some cases, certain healthcare insurance providers may not directly cover a procedure, but will provide reimbursement after it is completed. This has become common with certain health insurance carriers and simply requires you to prepare and submit paperwork to them after receiving your procedure, as opposed to this being handled directly between your doctor's office and the insurance company.
Again, these are questions for your doctor and insurance company, firstly to inquire whether your doctor is within your health insurance carrier’s network or otherwise able to work with your insurance company, and secondly, whether your actual insurance company itself will cover (or reimburse) the individual treatment or procedure.
If you are considering a cosmetic surgery or other procedure and wondering whether or not it will be covered by your insurance, hopefully this information has been helpful. Many cosmetic surgeons also offer financing options for patients unable to receive insurance coverage or reimbursement for their procedures. You may wish to ask your cosmetic surgeon your cosmetic surgery insurance coverage and financing questions to see if any of these options may be available to you.