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Plastic Surgery Procedures Eligible for Insurance Coverage

Posted August 13, 2012 in Breast Reduction, Eyelid Surgery (Blepharoplasty), Rhinoplasty

woman legsAt the practice of San Francisco plastic surgeon Kimberly Henry, we receive a lot of inquiries regarding whether the cost of the procedures we offer can be covered, in part or in full, by insurance. In most cases, unfortunately, the answer is a definitive “no.” Most insurance companies do not cover any surgery that is performed for cosmetic reasons as these surgeries are considered elective rather than medically necessary. However, many policies do cover, at least in part, plastic surgery procedures intended to correct physical abnormalities or injuries, relieve pain, or produce demonstrable health benefits.

Often, a single procedure can be interpreted as cosmetic or as corrective, depending on the context in which it is being performed. For instance, upper eyelid surgery may be approved by various insurance plans if the patient is having it performed because hanging skin is interfering with his or her vision. Even though the procedure is legitimately being performed for a serious medical purpose, the cosmetic benefits are absolutely the same as they would be for someone having it performed simply to improve the appearance of his or her eyes. In such cases, subjective interpretation can make all the difference.

Our plastic surgery experts would, of course, be pleased to advise you as to whether your insurance plan is likely to approve your procedure to any degree. That said, it is a good idea that you speak with a representative of your insurance company before pursuing surgery of any sort. It doesn’t hurt to ask, and who knows? You might find that, for some or all of your San Francisco plastic surgery, insurance may provide some economic relief.

Breast Reduction

Among the plastic surgery procedures available at our practice in San Francisco, breast reduction is the one most commonly covered, at least in part, by medical insurance. This is because the procedure is often performed to alleviate physical pain and discomfort. As many of our patients know all too well, having disproportionately large breasts can cause a variety of ailments, including back, neck, and shoulder pain, bra strap indentations on the shoulders, and even skeletal deformities. While having the breasts be in better proportion with the rest of the body is clearly a wonderful cosmetic benefit, freedom from pain is the highest priority for most breast reduction patients. Because of this, a great many insurance plans will offer coverage of this procedure.

Other Procedures Sometimes Covered by Insurance

Other procedures available at our San Francisco plastic surgery practice that are sometimes covered by insurance include:

  • Rhinoplasty: When performed to correct breathing problems or physical defects, rhinoplasty may be covered by insurance.
  • Facial plastic surgery: Surgery to correct disfigurement of facial features due to injury or disease may be covered by insurance.
  • Eyelid surgery: As stated above, there may be medical reasons for having to undergo eyelid surgery, in which case the procedure may be covered by insurance.
  • Any surgery performed to correct physical abnormalities or birth defects

To learn more about any of the procedures we offer at our San Francisco plastic surgery practice, please contact Kimberly Henry, M.D. today. For answers to questions regarding your insurance coverage, we urge you to contact your insurance provider.

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