Role of Insurance | Plastic Surgery Costs
Now that you are exploring the cost, price, financing, and other payment options associated with plastic or cosmetic surgery, it is important to know if your procedure is covered by traditional insurance.
The rule of thumb is that if the service is medically necessary or appropriate to treat a medical condition or ailment, then the service is generally covered by insurance.
In the case of plastic surgery, insurance pays for those cases that are reconstructive due to malformation or injury.
Additionally, if the case is to restore proper functioning, to relieve pain or suffering, or treat other medical condition, there very well may be insurance coverage.
Examples:
If you're in doubt about your eligibility for insurance coverage, contact your insurance company for guidelines and rules, or your employer for a copy of your summary plan description.
If you need to appeal a coverage determination, make sure you understand rules and ask your physician to write a letter explaining how your case or procedure is medically necessary or how it fits the particular coverage criteria of your insurance company.