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Plastic Surgery Costs and What Insurance May Cover

Who Pays for Cosmetic, Reconstructive, and Plastic Surgery Costs?

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According to the American Society of Plastic Surgeons, approximately 6.6 million Americans had plastic surgery in 2002. That comes out to a lot of money in doctor fees, so who is paying for plastic surgery costs? Well, that depends.

Who pays for plastic surgery costs depends entirely on your insurance company. Although insurance policies can be very different on what is considered a covered procedure, there are some guidelines most insurance companies adhere to when it comes to definitions of what is considered reconstructive and what is considered cosmetic. Most insurance companies follow the definitions given by the AMA (American Medical Association) and the ASPS (American Society of Plastic Surgeons) which state:

  • Reconstructive surgery refers to surgery performed on abnormal structures caused by congenital defects, developmental abnormalities, trauma, infection, tumors, or disease. This can include surgery to improve function or to give a normal appearance.
  • Cosmetic surgery is the reshaping of normal structures on the body to improve the self-esteem or appearance of a patient.

    Insurance companies are the interpreters of the above definitions. Take for example the procedure of circumcision on infant boys. In the past all insurance companies paid for this procedure, but it is now becoming more common that insurance companies will not pay for the procedure because is considered cosmetic. What is considered cosmetic is entirely up to what insurance company holds your policy.

    Accordingly, this could mean that the nose job you have been seeking or the droopy eyelid you have been wanting to get rid of could now be covered. Here is more about plastic surgery costs and a list of common procedures that may now be covered by your insurance.

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