Will My Insurance Company Cover Plastic Surgery?

March 10th, 2016

The answer is yes, and no. Depending on the procedure and certain criteria determined by your insurance company, some procedures will be covered. The real problem is a global misunderstanding and disconnect between the patient and insurer over the inadequacies of covered procedures, deductibles, networks, and other pre-existing gaps in individual and group insurance. A majority of the plans offered through employers and health care exchanges today have large deductibles which equate to the patient being solely responsible for their own healthcare coverage and can lead to unforeseen expenses. It is much easier for patients to blame physicians, who are physically present and closer, than blaming an insurance company, which can be surprisingly vague about healthcare coverage.

Why Isn’t My Plastic Surgery Procedure Completely Covered by Insurance?

For every dollar spent on healthcare, insurance companies take 30 cents and provide absolutely no medical benefit. Insurance companies prey on the fact that doctors are healers and will provide care without regard to the cost to themselves emotionally, spiritually, and financially. The business of medicine is the only arena, where every year the cost of providing care increases while insurance carriers decrease their reimbursement and simultaneously shift the financial burden to the patient. All the while they are able to blame rising cost on physicians. Whenever patients have a problem with their insurance carrier the physician becomes the scapegoat.

How Can I Avoid Unexpected Medical Expenses for My Procedure?

For many years, insurance carriers have purposefully kept patients in the dark regarding the exact details of their plans. When coverage is denied they immediately shift the blame to physicians who provided the care that the patients have requested and most often demand. It is appalling that insurance carriers do not have full transparency and even more disturbing that patients ignore this fact. By familiarizing yourself with coverage and getting approval prior to your procedure, you will avoid unexpected costs that can prevent you from fully enjoying the positive changes wrought by plastic surgery.

If you are interested in a consultation or have additional questions, please call our Conroe office at 936.539.8115.