FAQ About Plastic Surgery

In most cases, insurance does not cover the cost of elective cosmetic surgery, as it is considered to be for aesthetic purposes rather than medical necessity. Cosmetic procedures that are solely performed to improve appearance or enhance features, such as breast augmentation, rhinoplasty, or facelifts, are typically not covered by insurance.

However, there are situations where insurance may provide coverage for plastic surgery procedures if they are deemed medically necessary or reconstructive in nature. Here are some examples:

• Reconstructive Surgery: If plastic surgery is required to restore function or correct abnormalities resulting from congenital defects, trauma, or previous medical treatments, insurance may cover the cost. Examples include breast reconstruction after mastectomy, cleft lip and palate repair, or reconstruction after severe burns or accidents. Coverage may vary depending on the specific insurance plan and its criteria for medical necessity.
• Corrective Procedures: Some plastic surgery procedures may be covered if they are deemed necessary to correct a functional problem or alleviate physical discomfort. For instance, breast reduction surgery to relieve chronic back pain or reconstructive nose surgery to address breathing difficulties may be eligible for insurance coverage.
• Documented Medical Need: In cases where a plastic surgery procedure has a clear medical indication and is supported by medical documentation, insurance coverage may be considered. This typically requires the submission of medical records, photographs, and a detailed explanation from the treating physician or plastic surgeon.