Does Private Health Insurance Cover Cosmetic Surgery?

If you have private health insurance from the ACA Healthcare Marketplace (Obamacare), from your employer, or that you’ve obtained directly from an insurance company or broker, you may be wondering what it covers. Does private health insurance cover cosmetic surgery? Read on, and get the answers you need from My Private Health Insurance.

What Is Cosmetic Surgery? Understanding The Basics

Cosmetic surgery is any procedure that’s done to change, enhance, or restore your appearance. There are many reasons you may want to get cosmetic surgery, such as to correct a birth defect, to correct your appearance after an injury like a major burn that may have required skin grafting, or even just to improve your personal appearance.

Elective Cosmetic Surgery Is Not Usually Covered By Private Health Insurance

Elective cosmetic surgery is a procedure that’s done for reasons that are not related to your health.

For example, if you are unhappy with how your nose looks and you want to get a nose job (rhinoplasty), this is an example of “elective” surgery – the surgery is being done because you want it, not because of any health reason.

This type of cosmetic surgery is almost never covered by a private health insurance plan, because it’s not “medically necessary.” Procedures that are not medically necessary are very rarely covered by health insurance.

So, does this mean that your insurance company will never cover the cost of cosmetic surgery? Not necessarily – find out why below!

Reconstructive Or Health-Related Cosmetic Surgery Is Typically Covered By Insurance

Cosmetic surgery is not just used to change your appearance – but also may be required to restore your appearance after a serious accident, or due to an issue caused by a congenital defect.

This type of “reconstructive surgery” is usually covered by your private health insurance policy. Let’s say that you were hiking on a steep trail, and you had a serious slip and fall that resulted in the tearing of your eyelid and a broken, disfigured nose, as well as lacerations to your face.

In this case, reconstructive surgery may be required to restore your eyelid, and to repair your nose and restore its appearance. This type of surgery will usually be covered by insurance, but your health care provider will have to prove to your insurer that it’s “medically necessary.”

Basically, as long as the surgery can be proven to address a serious medical concern, cosmetic surgery will be covered by your private health insurance policy, in most cases.

Need Private Health Insurance? We’re Here To Help!

At My Private Health Insurance, our team of expert health insurance brokers can help you find a private health insurance provider that will offer the benefits and coverage you need – no matter your situation or your budget. So don’t wait – contact us online or give us a call at 754-206-9583 to get started and get the assistance you need.