Does Health Insurance Cover Cosmetic Surgery?
Updated On Oct 18, 2022
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With the modern lifestyle, the demand for cosmetic surgeries such as nose reshaping, face uplift, eyelid surgery, and many others has simultaneously increased. However, the cost incurred during the procedure of cosmetic surgeries is not covered in the mediclaim policies. The primary reason for not providing coverage for cosmetic surgeries and procedures under a health insurance policy is that they are not considered vital to sustain life or ensure the correct functioning of a body part or system.
Bearing The Cosmetic Procedure Cost
Like all other treatments, the cost and safety involved in cosmetic procedures are the primary goals to be considered. Under the health insurance policy, check if the cosmetic surgery is covered or not. Most health insurance companies, check whether the process was cosmetic or reconstructive surgery at the time of claim settlement.
Listed below are medical procedures that are related to one another while still being relatively different from one another.
- Cosmetic Surgery:
In these types of procedures, a specific body part is given a whole new look and appearance. Mostly, people undergo cosmetic procedures to boost their confidence and self-esteem in them.
- Reconstructive Surgery:
This surgical method is performed to treat trauma, physical defects, diseases, or ailments caused because of an accident or any genetic abnormality. Usually, these surgeries improve the overall aesthetics of the affected body part/ organ normalizing its functioning and appearance.
Therefore, most cashless medical policies do not cover cosmetic surgeries but provide benefits for reconstructive surgeries, even though both processes are carried out by the same medical practitioners.
When Does The Policy Cover Plastic Surgery?
The definition of a medical procedure and your provider's guidelines will determine if plastic surgery is covered in your health insurance policy. It's critical to ascertain the following in order to understand if the procedure is protected under your policy:
- The procedure undergone is constructive.
- Is the procedure life-saving?
- Or the surgical process is cosmetic.
If the process is life-saving or reconstructive, then usually the medical expenses incurred will be covered under the insurance policy. The best way to find out is to contact your insurance provider directly with all the details of the surgical process to get a methodical understanding of the coverage provided under your health insurance policy.
The following popular procedures are covered under health if you chose one that includes plastic and reconstructive surgery:
- Surgeries are carried out following events of burns such as grafting, reconstruction, and skin tightening.
- Surgeries are performed to regularize congenital anomalies such as the repair of cleft lips, cleft palates, and nasal deformities that cause breathing difficulty.
- Reconstructive surgeries are performed to normalize shocking injuries.
- Scar repair
- Surgeries followed by treatment of tumors or cancer
The health insurance companies that offer coverage have increased along with the popularity of plastic and cosmetic surgeries. To choose the best plan at the finest price, you can evaluate, analyse, and shortlist different insurance providers and plans based on your needs.