There are many reasons to consider plastic surgery. You may assume surgery is only for wealthy women trying to hang onto their fleeting youth. If so, you may be surprised to know that the waiting room at a plastic surgeon’s office is populated with a variety of people from all walks of life. Many times, plastic surgery is not merely an elective procedure done out of conceit or to enhance the appearance. In many cases, plastic surgery is a necessary operation done to improve health and quality of life. Read on for 11 examples of when plastic surgery is something your insurance company may be willing or required to pay for.
11. Nose Job (Rhinoplasty)
You may think of a nose job as a cosmetic procedure to make your nose smaller or to smooth out a hooked beak. Insurance companies do not pay for nose jobs done for purely cosmetic reasons. However, several rhinoplasty procedures are considered medically necessary. According to plastic surgeon Dr. Bradford S. Patt, a nose job may be medically necessary if you have chronic sinus issues that interfere with your ability to breathe easily. Chronic inflammation due to allergies, an injury to the face, and deformities such as a deviated septum are issues that may be resolved by rhinoplasty.
10. Ear Surgery (Otoplasty)
Your insurance may balk at paying for ear surgery if your sole complaint is that your ears are too big. According to the American Society of Plastic Surgeons, the average cost of cosmetic ear surgery was $3,156 in 2018. Your insurance company will probably only foot the bill for ear surgery if the deformity interferes with your hearing. The Mirage Center suggests that otoplasty can be medically beneficial if a misshapen ear increases your risk of skin cancer. This may happen if the ears protrude so far that the delicate skin above the ear is overly exposed to sunlight.
9. Eyelid Lift (Blepharoplasty)
Eyelid surgery can reduce the appearance of sags and wrinkles, remove fatty deposits from around the eyes, or fix drooping eyelids. Again, your insurance company won’t shell out money in an attempt to restore your youthful appearance. However, there are some instances in which blepharoplasty is medically necessary. Blue Cross Blue Shield may pay for eyelid surgery in cases where a sagging eyelid or weak muscles interfere with proper vision. Blepharoplasty may also be covered to repair defects where trauma, injury, or disease have damaged the eyelids and cause pain or difficulty seeing.
8. Mole Removal Surgery
Insurance companies may pay for mole removal if the mole appears suspicious, is large, or is located in an area where it may be irritated by clothing. The American Academy of Dermatology reminds you to watch for the ABCDEs of skin cancer. A stands for asymmetry, or a mole that has halves that do not match. B is for an irregular or jaded border. C is for a mole with more than one color. D is for a diameter larger than a pencil eraser. E is for a mole that evolves or changes in appearance over time.
7. Breast Reconstruction
Your insurance company is not likely to pay for surgery to enlarge your breasts for cosmetic reasons. Longing for larger breasts or wanting to repair signs of normal aging will not qualify as medically necessary procedures. However, following a mastectomy, insurance companies are required to pay for reconstructive surgery on not only the affected breast, but the other one as well. The Women’s Health and Cancer Rights Act states that all stages of reconstructive surgery on both breasts and treatment for any complications must be covered by your health plan.
6. Breast Reduction (Reduction Mammoplasty)
Large and heavy breasts can cause many painful and uncomfortable medical issues. The weight of large breasts can cause strain to back and neck muscles. Large breasts can hinder physical activity due to pain and discomfort. Furthermore, rashes, infections, and skin issues can develop beneath the breasts. Insurance companies may pay for surgery to provide relief, but they may first require a patient to attempt other methods of relief. According to the American Society of Plastic Surgeons, you may need documentation from a chiropractor, dermatologist, or orthopedist before surgery is approved.
5. Excess Abdominal Skin Removal (Panniculectomy)
Once you’ve dropped the pounds, major weight loss can leave behind droopy folds of saggy abdominal skin and fatty tissue. United Healthcare states that a panniculectomy is considered medically necessary if certain criteria are met. First, the panniculus, or fold of skin, must hang at or below the joint connecting the pubic bones. Second, the panniculus must cause certain skin conditions such as sores or infections. Third, the excess skin must interfere with daily activities and normal function. Finally, the goal of the proposed surgery must be an improved ability to perform daily activities.
4. Tummy Tuck (Abdominoplasty)
A tummy tuck differs from a panniculectomy in that your surgeon removes fat as well as excess skin. Furthermore, this procedure involves tightening the abdominal muscles beneath the layer of fat. This operation is generally considered cosmetic, even in the case of stretched abdominal muscles and skin following pregnancy. However, following a mastectomy, your physician may remove skin, blood vessels, and fatty tissue from your abdomen to use to reconstruct your breasts. Procedures that transfer tissues from the abdominal area to the breast area include a SIEP flap and a DIEP flap.
3. Butt Lift
Contouring the buttocks is a cosmetic procedure. However, breast reconstruction following a mastectomy may include removing tissue from the buttocks to form new breast tissue. Of course, it is far preferable not to have to endure the pain, stress, and worry of breast cancer. If you are feeling dissatisfied with your derriere, Fitness Magazine has tips for a 7-Minute Workout: Booty Boot Camp. This workout includes exercises like squats, butt kicks, butt lifts, and leg lifts to strengthen and tone your leg and gluteal muscles.
2. Bunion Surgery
While wearing poorly fitting shoes can contribute to the formation of bunions, this condition is also hereditary. Your pretty sandals may not look as lovely if you suffer from the knobby bump and characteristic angled big toe of bunions. However, this foot deformity is more than just a cosmetic problem. Many insurance companies will pay for bunion surgery when the bunion is accompanied by pain, balance problems, and difficulty walking. If you suffer from a bunion on one or both feet, you may have trouble finding shoes that will fit properly, making the problem even worse.
1. Varicose Veins
The ropy, purplish, bulging veins that sometimes appear on the legs may also be more than just a cosmetic problem. These unsightly veins are caused by weakened valves in your blood vessels. Weak valves prevent your blood vessels from getting your blood back up to your heart from your lower legs. As blood collects in your blood vessels, they can become stretched and twisted. Insurance companies may pay to fix this medical problem when varicose veins cause pain, swelling, and pooling of blood in the veins.