What Types Of Plastic Surgery Procedures Are Covered By Insurance?

When most people think of plastic surgery, cosmetic procedures such as a facelift or breast augmentation come to mind. However, the truth is that not all plastic surgeries are purely cosmetic. Many procedures performed by plastic surgeons actually have health, lifestyle, and psychological benefits that go far beyond aesthetics. For men and women considering these procedures in an attempt to correct a physical, medical, or emotional problem, it is perfectly natural to wonder whether or not insurance may help cover the surgery.

The caring team at VIP Plastic Surgery in Las Vegas, NV, led by board-certified plastic surgeon Dr. Christopher Khorsandi, is dedicated to helping patients achieve their goals and address their concerns in the most convenient and affordable – yet effective – way possible. Our knowledgeable office staff will work with you to find out whether a portion of your desired procedure may be able to be covered by your insurance carrier. To learn more about which procedures are sometimes covered by insurance, as well as how to go about getting them covered, read this helpful guide below.

Is cosmetic surgery ever covered by insurance?

Yes and no. The key in determining whether or not a procedure may be covered by insurance is to establish the purpose of the surgery. Procedures that are performed purely for cosmetic reasons, such as a facelift to improve an aging patient’s appearance, are not considered medically necessary and are therefore not covered by insurance. However, some procedures that may result in secondary cosmetic benefits – but are performed primarily for medically necessary reasons – may be partially or sometimes fully covered by an insurance company. A good example of this is rhinoplasty. For patients who have severe difficulty breathing, perhaps due to a deviated septum or a narrow nasal passage, rhinoplasty can certainly be beneficial in achieving unobstructed airflow. As a side benefit, the patient may end up with a more appealing nose in terms of size, shape, and contour.

During your initial one-on-one consultation, Dr. Khorsandi will thoroughly evaluate your complaints and concerns, answer your questions fully, and discuss your available options in detail, including what procedures may or may not be covered by insurance.

Some additional plastic surgery procedures that are commonly covered in part by medical insurance include:

• Breast reduction: When a woman experiences chronic and debilitating back pain, skin rash, or other physical issues which can be attributed to overly large or heavy breasts, a breast reduction can be a fantastic solution. If an insurance company determines that the patient’s symptoms are enough of a hindrance to her daily life that the procedure can be considered medically necessary, then it may be covered or partially covered.
• Breast reconstruction: For breast cancer patients who have undergone a mastectomy, or women that have suffered a traumatic injury to the breast, breast reconstruction and/or augmentation may be covered by some insurance providers.
• Rhinoplasty: As discussed above, when a rhinoplasty, turbinectomy, or septoplasty is deemed medically necessary in order to help a patient breathe freely, it may be covered by insurance.
• Eyelid surgery: In cases where hanging or droopy eyelids are impairing a patient’s vision, it is possible an insurance company may cover eyelid surgery, also known as blepharoplasty.
• Skin removal: While weight loss surgery itself may be covered by some insurance providers, after weight loss procedures are considered cosmetic for the most part and unfortunately are not covered. In rare cases, however, excess skin after weight loss may pose enough of a problem that it is considered medically necessary to have it removed. When the skin hanging from the lower abdomen causes a patient to have repeated infections or painful rashes, for instance, a panniculectomy may be covered by insurance.

How do I get my plastic surgery covered by insurance?

While the final decision on whether or not your procedure will be covered lies with your insurance provider, there are some proactive steps you can take to make the process of determining coverage as easy as possible:

• Document your condition and symptoms with photos and trips to the doctor
• Prove that you have tried other methods and treatments unsuccessfully before resorting to surgery as a last option
• Keep detailed records of any medications, office visits, trauma, or anything else that pertains to the condition
• Select a qualified, board-certified, and reputable plastic surgeon – along with a distinguished surgery center – to provide your care. This will help your chances of getting your insurance company to consider your case.

If you think your condition may justify a medically necessary plastic surgery procedure that can be covered by insurance, call the Las Vegas office of VIP Plastic Surgery to schedule your consultation with board-certified plastic surgeon Dr. Christopher Khorsandi today. We would be honored to help you find relief from your symptoms and will work closely with you to determine whether or not you may be eligible to have your procedure covered by insurance.