In part one of this two-part blog series, we went over some of the key factors at play in whether your plastic surgery procedure will be covered by your insurance. Medical necessity is the most significant variable at play here, but there are also others to consider – and ultimately, whether you’re covered may come down to specific and individual factors.
At the offices of Steven Warnock MD, we’re proud to offer a wide range of high-quality plastic surgery treatments to patients around Salt Lake City and other parts of Utah, from body sculpting and breast surgery to mommy makeover services and more. Today’s part two of our series will pick up where we left off: Running through several common plastic surgery procedures and whether they will typically be fully or partially covered, plus some specific considerations within each.
Breast Augmentation or Reconstruction
As we discussed in part one of our series, medical necessity is the primary factor here: If a procedure is deemed medically necessary, it is typically covered at least in part by insurance. Breast reconstruction or augmentation (which can be done for medical reasons) generally falls into this category. For instance, women diagnosed with breast cancer who require mastectomy will virtually always be covered.
However, depending on your insurer and specific policy and/or plan, coverage may vary to some degree in other cases as well. For example, you might be covered if you are a transgender woman undergoing breast augmentation, but coverage could vary depending on your plan and insurer.
Breast Implant Removal
In most situations, breast implant removal will typically not be covered by insurance – this is because most of the reasons for this are cosmetic in nature, and thus not medically necessary.
However, if you meet certain criteria – such as if your implants have ruptured or are causing pain or health problems – you may. It’s best to speak with your insurer and plastic surgeon about the specifics of your case in order to determine coverage.
Certain Forms of Body Sculpting
One of the more nuanced areas of plastic surgery coverage is body sculpting – typically, procedures like tummy tuck and liposuction are done for cosmetic reasons and not covered by insurance. However, if you have a significant amount of excess skin that’s causing health problems or interfering with your ability to move freely, this may be considered medically necessary (and thus eligible for partial coverage or coverage in full).
Again, the best thing to do is speak with your insurance provider and plastic surgeon about your specific case.
These are just a few of the most common types of plastic surgery procedures – but as we mentioned before, individual policies can vary significantly depending on your insurer, specifics of your plan and other factors. And of course, even if your procedure isn’t covered by insurance, you may have other options to finance it – including payment plans and other financing options.
At the offices of Steven Warnock MD, our patient care staff can help you with these and any other questions you may have about financing your plastic surgery treatment. Contact us today to learn more.