What Types of Plastic Surgery Does Insurance Cover?

Will Insurance Cover Plastic Surgery?

More people than ever are getting plastic surgery to look and feel their very best. One the first question we are asked by patients at our Birmingham cosmetic surgery practice is “Will Insurance Cover Plastic Surgery?” The answer depends upon the type of surgery you are having, as well as the reasons you are having it. 

If a plastic surgery procedure is considered “purely cosmetic” (with no medical benefit), health insurance will typically not cover the procedure. However, there are a dozen or so cosmetic surgeries that insurance policies may cover if certain conditions are met.  If a patient can prove medical necessity, all of the surgeries listed below may be at least partially covered by insurance.

“Nose Job” Surgery

Rhinoplasty, also known as a nose job, may be covered by your insurance in cases where the nose’s structure makes it difficult to breathe. An example of this is a deviated septum, which can cause many health problems like pain, nosebleeds, and obstruction of nostrils.

Eyelid Lift Surgery

Blepharoplasty, or an eyelid lift, can be done on the upper and lower eyelids, and for both cosmetic and medical reasons. If it can be shown that the surgery falls into the latter category, your insurance may cover it.

One common medical reason for blepharoplasty is when extra skin puts too much weight on the eyelid, causing obstruction of vision. Insurance may also cover an eyelid lift when vision is impaired by muscles of the upper eyelid stretching too much over time. If insurance coverage is sought, you will likely have to provide medical documentation from an eye doctor.

Ear Reshaping Surgery

Though less common than eyelid surgeryOtoplasty, or ear reshaping surgery, can similarly be covered if the anatomy of the ear impairs hearing. Various anatomical conditions pertaining to position and proportion of the ear can interfere with hearing.

Mole Removal Surgery

Some people love their Moles, also referred to as “beauty marks.” Others prefer they be removed. If a mole is deemed “suspicious,” pre-cancerous, or cancerous by a doctor, insurance typically covers the removal procedure.

Having a mole removal done by a board certified plastic surgeon ensures that there is minimal or no scarring, and that you are not left with any disfigurement.

Breast Surgery

Breast procedures, including augmentation, lifts, and reductions, may be covered by insurance for several reasons. In cases where the breast surgery is deemed reconstructive (as opposed to solely cosmetic), insurance typically covers all or part of it. An example of this would be following a mastectomy due to breast cancer. In fact, 1998 legislation mandated that insurance cover not only reconstruction of the removed breast, but also for work on the remaining breast for symmetry purposes.

Another reason insurance companies may cover breast surgery is for relief of severe discomfort. Breast reduction procedures, and possibly a breast lift, would be two such examples.  The weight of some women’s breasts may cause back, neck, and shoulder pain and could warrant medically necessary surgery. As with any insurance claim, sufficient documentation of the condition must be supplied by the woman’s doctors and health care providers.

Other Plastic Surgery Procedures Covered by Insurance

Other cosmetic procedures that insurance will sometimes cover include, but aren’t limited to, tummy tucks, butt lifts, bunion removal, and varicose veins removal. Again, the most important criteria is that these surgeries are deemed medically necessary and/or are used for pain relief. For the best information about insurance coverage, it’s always best for policyholders to contact their insurance companies directly.

Best Plastic Surgery – Birmingham, MI

If you’re interested in seeing what plastic surgery procedures might be covered by your insurance, make an appointment for a free consultation with Dr. Ali today.  You may also call 855-335-7200 to speak with our caring and informative office staff.

With over 7,000 plastic surgery procedures to his name, board-certified Dr. M. Azhar Ali is an outstanding Birmingham area plastic surgeon, who offers experienced, compassionate care to all patients. We will work with your insurance company and make every effort to help you obtain coverage for your medically necessary plastic surgery.