What Health Insurance Covers Plastic Surgery?

1. 

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   Marlin McKelvy

   President, Consumer Directed Benefit Solutions, Memphis, Tennessee

   Essentially all health insurance plans will cover some forms of plastic surgery. The crucial distinction that the consumer must understand is the difference between reconstructive plastic surgery and cosmetic plastic surgery. For example, accidents, burns from fires or chemicals, and some cancer treatments trigger the medical necessity criteria necessary for restoring or at least improving the normal functions of an individual. This is totally different than you deciding you would feel better about yourself if you had your favorite movie star's nose or breasts. That would be a purely cosmetic procedure with no bearing on your physical health (if fact, you are actually putting your physical health at risk). If you want to pay to look like a real life Barbie Doll then go for it but your health insurance company loves you just the way you are.

   Answered on September 12, 2014

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2. 

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   David G. Pipes, CLU®, RICP®

   Business Development Officer, T.D. McNeil Insurance Services, Fresno, California

   Medical treatment to enhance the appearance is generally not covered by any medical insurance. Treatment to correct damaged skin is generally covered, particularly when it is medically required. In an interview with a plastic surgeon, I was told that it is difficult for them to draw the line as some repairs lapse into cosmetic surgery. For example, surgery on the eyelid can increase the beauty of the eye but it can also help a person from having strikes to their head from low objects such as cabinets.

   Answered on March 9, 2015

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