Insurance Coverage Of Cosmetic Surgery
Post by glenda
Filed under Cosmetic Surgery
Before making the decision to have cosmetic surgery, you should investigate the total cost of your desired procedure. Insurance coverage will vary for each cosmetic surgery and insurance company policies will also differ. It is important to consider the financial aspects of surgery before making the decision. Knowing the covered costs by your insurance policy; as well as for which surgeries they will pay, will help you determine whether you can financially afford cosmetic surgery.
The American Medical Association as well as the American Society of Plastic Surgeons both provide guidelines to insurance companies. These guidelines are used to set the guidelines covering each surgery. Each insurance company then takes these guidelines to use them in order to interpret whether they will pay for the specific requested cosmetic surgery. This differs from one insurance company to another and potentially from one type of policy to another. Over the years, these guidelines have been altered and reinterpreted creating different standards. Procedures that were once labeled cosmetic are now considered reconstructive and others, that were at one time considered reconstructive, are now considered cosmetic.
An insurance company will determine if the particular requested cosmetic surgery fits their policies’ guidelines for payment. If the surgery is desired for purely cosmetic reasons, typically it will not be covered. However, there are guidelines to help define whether a particular surgery is cosmetic surgery or surgery needed to correct a medical problem. If you have an abnormality that needs correcting, the majority of insurance companies will cover all or some part of the surgery. Additionally, if surgery will result in an improvement in your mental health, the insurance company might cover it.
Guidelines can help an insurance company decide if abdominal surgery or liposuction will be performed with the goal of improving a person’s health, or if it is desired for strictly cosmetic purposes. If you are considered obese and have back pain, or other related problems and it is indicated that abdominal surgery will eliminate those problems, such surgery may be covered. Breast surgery in generally covered by insurance policies if the breasts are causing pain, are asymmetrical, or if you have lost a breast as a result of cancer or another surgery.
If you are seeking surgery on some area of your face, the desired surgery generally needs to be related to some medical problem in that area. If the area causing you concern relates to birth defects, your surgery may be covered by insurance. The insurance carrier may approve payment for an imbalance in the face, abnormal functioning of the facial area, and vision problems. If the structure of your nose is interfering with your ability to breathe, rhinoplasty may also be covered by insurance.
Typically, cosmetic surgery costs a minimum $2,000, with $5,000 being considered average, and some surgeries cost greater than $10,000. The surgery cost will depend on how complicated your surgery is. If you are unable to pay the cost of the surgery, but your doctor’s opinion is that it will improve your health, your insurance company may still approve payment. Finding a company that has policies that meet your cosmetic surgery needs, can help you to make the necessary changes to your body. Consulting your doctor prior to contacting the insurance company will help both of you to prepare for questions the company may pose.
Charles Anderson
http://www.articlesbase.com/medicine-articles/insurance-coverage-of-cosmetic-surgery-96643.html



Health insurance coverage conflict with surgery done abroad.?
Hi,
I am considering traveling abroad for non-cosmetic surgery. The main reason for doing so is the quality of care I can afford (several weeks on intensive physical therapy).
I already had one surgery for same issue here in US with limited success, and fear going thru a "re-do" even with another doctor that participates with my insurance (not the best in the world). Hence the decision of going abroad..
So, if I have a surgery abroad – can my insurance at some point "stick it to me" and deny me coverage if I ever have another problem related to this surgery abroad???
I'm trying to find out the consequences of seeking medical help abroad, and the insurance coverage is the first one that comes to mind.
About costs:
1. If I get it done here in US, with current insurance my copay is barely $300 for the surgery + $35/each phys therapy session.
2. Abroad: A lot more expensive.
The only reason for doing abroad is the reputation of doctor doing surgery & quality of care. It is a ortho surgeon that mainly operates on prof. soccer players in south america.
Pre-existing conditions are generally due to diseases or malformations that are natural, not related to surgeries.
I suppose they wouldn't do after-care for the surgery, like stitch removal or subsequent surgeries for repair or whatever, but you should be covered for general health issues.
You might want to check on what your company considers a "pre-existing condition." They may well not cover items directly related to your surgery if you got it done outside of the country, because one of the ways insurance saves money is by keeping you within a certain network of approved providers.
I'd also say, make 100% sure that your insurance won't cover something here. Yeah, it may be cheaper to do something overseas…but do you really want to have to go back overseas for aftercare? Do you want to try to sue an overseas doctor for malpractice? You may not even have any legal recourse if something goes wrong with the surgery in another country (since it didn't work that well the first time, that's a definite consideration.)
The cost savings…might not turn out to save you any money at all. If you're looking at the worst-case scenario, it might be better to spend more for care in your own country than deal with a fiasco based in another country.
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