Many people use cosmetic surgery to enhance their appearances or correct physical abnormalities. However, cosmetic surgery can be costly. For this reason, many individuals wonder whether their health insurance can cover the expenses.

Cosmetic surgery may or may not be covered under your insurance, depending on certain factors. In this article, we will discuss when health insurance covers cosmetic surgery.

What is Cosmetic Surgery?

Cosmetic surgery includes a range of procedures that are performed to enhance an individual’s appearance. These procedures are elective, which means they are not necessary for a person’s physical health.

Cosmetic surgery includes procedures such as breast augmentation, liposuction, facelifts, tummy tucks, and rhinoplasty, among others. The primary goal of cosmetic surgery is to improve aesthetics rather than treat a medical condition.

Coverage for Cosmetic Surgery

In general, health insurance does not cover cosmetic surgery. However, there may be some exceptions. In certain cases, health insurance may cover cosmetic surgery if the procedure is deemed medically necessary.

Medical Necessity

If your doctor recommends cosmetic surgery to treat a physical abnormality or medical condition, your health insurance may cover the procedure.

Cosmetic surgery is considered medically necessary when it is essential to treat a condition that impairs your bodily function or causes you significant physical or emotional distress.

Examples of Medical Necessity for Cosmetic Surgery

There are several medical conditions that can be treated using cosmetic surgery. Here are some examples:.

1. Breast Reduction

Some women with larger breasts may experience back pain, neck pain, and other physical symptoms. Breast reduction surgery can reduce the size of the breasts, relieving the physical symptoms and improving the quality of life.

If the woman’s plastic surgeon and her physician confirm that the surgery is needed for medical reasons, her health insurance may cover the expenses.

2. Rhinoplasty

Some people may experience difficulty breathing due to a deviated septum or other abnormalities in the nose. A plastic surgeon may recommend rhinoplasty to improve nasal breathing and reduce the risk of sinus infections, among other benefits.

If the surgery is performed for medical reasons, your health insurance may cover it.

3. Eyelid Surgery

Eyelid surgery, or blepharoplasty, may be considered medically necessary if sagging eyelids obstruct an individual’s vision. The procedure can improve an individual’s ability to see, reducing the risk of accidents and improving the quality of life.

If the surgery is performed for medical reasons, your health insurance may cover it.

Cosmetic Surgery that is not Covered by Insurance

Most cosmetic surgeries are not covered by insurance since they are elective and not deemed medically necessary. Examples of such surgeries include:.

1. Breast Augmentation or Lift

While breast augmentation or lift can improve a person’s appearance, it is not medically necessary. Therefore, it is typically not covered by health insurance.

2. Liposuction

Liposuction is a cosmetic surgery aimed at removing fat deposits from the body. It is not considered medically necessary, and as such, health insurance does not usually cover it.

3. Facelifts and Botox Injections

Facelifts and Botox injections are elective procedures intended to remove wrinkles and fine lines from the face. They are typically not covered by health insurance.

Conclusion

Cosmetic surgery is not typically covered by health insurance since it is considered elective and not medically necessary.

However, if your doctor recommends cosmetic surgery to treat a physical abnormality or medical condition, your health insurance may cover the expenses. Therefore, it is critical to consult with your health insurance provider to determine which cosmetic surgeries are covered, and which ones are not.