Plastic surgery focuses on repairing and reconstructs physical features of a human body. These surgeries are usually done to correct the defected area of the body to its normal appearance. The most common plastic surgeries include breast reconstruction, burn repairs, scar revision, eyelid surgery, ear surgery and septoplasty as well. Often people tend to get plastic surgeries to look better and make them feel good about their appearances, however such kind of surgeries are referred as cosmetic surgeries. Where the sole purpose of the surgery is to enhance the looks of the patient and does not take in account of any medical necessity.
The cost of getting any type of plastic or cosmetic surgery is a huge burden on any average person. To get a septoplasty, it can cost around $5000 including all the expenses of hospital and after surgery medications. The kind of amount needed to get these surgeries is rather large and not everyone can afford it. Getting it done through an insurance policy can make the surgery free of cost and accessible to many people who can’t afford it. The question remains, what kind of insurances cover what type plastic surgeries?
Basically, all the health related insurances are covered by a health insurance plan. Many working people are health insured by their jobs and some have opted for them manually. This type of insurance covers medical bills and surgeries, either the payments are made by the insured and then is reimbursed or the insurance company pays the bills directly. It all depends on the type of health insurance opted. There are three types of major health insurance plans: major medical, qualified health and catastrophic. There are some short term health plans available too.
Major medical health plan covers the basic medical bills and surgeries to be undertaken under the ambit of the Affordable care act. There is a time allocated in every year where people can apply for the major health insurance plan and receive medical coverage within 45 days. ACA declares all the Americans to have major health insurances. People can get insurances from the government or from a private healthcare exchange as well. There are situations where the people insured have the option to either pay their bills on their own or take the benefit of insurance coverage. Taking insurance coverage can cause higher payments of premiums; to paying off bills by oneself can lead to a lower burden on future expenses.
Essential health benefits are provided through the qualified health insurance plan. According to the ACA, no one will be denied a health insurance plan and those who refuse to take a health insurance plan will have to pay a certain tax. All the laboratory services, maternity and newborn care, ambulance services, chronic disease management, hospitalization and prescription drugs are covered under the qualified health insurance. These health benefits are also covered under the major medical health plan as well. The premiums to be paid under qualified health insurance are slightly lower and take limited liabilities towards insured people.
In case of a tragedy or accident, where some event took place unexpectedly, a catastrophic health insurance plan can cover payments effectively. For example if the insured person is diagnosed with cancer or had a heart attack, the insurance company takes full responsibility to pay off medical bills. In other severe cases of accidents where the body faces injuries, this health plan pays cash amounts to the insured personal. Moreover, a fixed benefit indemnity medical insurance plan under the catastrophic health plan will offer cash payouts will pay for specific surgeries and illnesses.
Major medical health insurance and qualified health insurance plans are prone in helping to pay for plastic surgeries if they have a legitimate medical reason to be carried out. Since there are limited resources to cover such surgeries and health issues, only those surgeries are covered by insurances which have a solid proof of distorting the medical condition of the patient. Those people who are looking for a surgery which will enhance the outlook of the body and has not medical liability will less likely be paid for the surgery. If the governments and insurance companies start to pay off all the kind of plastic and cosmetic surgeries taken place, they would practically go bankrupt. In the fiscal year 2013, almost 1.6million cosmetic surgeries took place; insurances have a hefty procedure to make sure that only those surgeries are paid which are actually deteriorating the health of the insurer.
The most common plastic surgery taken place is a breast reduction surgery. Women who feel that their large breasts are becoming a medical issue can get it done through a health insurance plan for free. There are many women out there who just want to get a breast reduction surgery to feel better about them or even get it done in order to “fit in” the society easily. Of course, large breasts can be a reason of embarrassment for women and may cause uneasiness while working in the society but this being the sole reason for the surgery would not help getting it done for free. Insurance companies demand a long history of back pain and shoulder troubles associated with the large breasts and other medical issues like pressure on the rib cage or a distorted posture. All these medical situations can be confirmed from a doctor and only then would an insurance company consider paying for it. Men can also get a gynecomastia surgery under the similar situations but it has different set of guidelines that can get it covered under an insurance plan.
Rhinoplasty can be covered by many health insurance plans; this surgery takes place to re-align the septum located in the nose. Usually people who face difficulty in breathing from the nose are known to have a deviated septum. It can be seen visually from the outside as well, if the septum is slightly tilted, the nose appears to be like a broken nose all the time. Under the serious condition of breathing problems only then does a health insurance company covers this surgery. Many of the insurance companies demand that the surgery taken place should have a long history of disturbances. As in the medical surgery to be taken place should have a documented medical history. In short, if someone is having difficulty in breathing, or the deviated septum is creating hindrances in normal day routine and the problem has a well-documented medical history. The insurance policy may cover the surgical procedure and the surgery would become free of cost.
An insurance company may also cover an eyelid surgery as well. Blepharoplasty is a procedure that is done on eyelid to reconstruct them. A distorted eyelid may hinder the vision. A series of vision tests will confirm whether the blepharoplasty will improve the vision or not. The distorted eyelid may also imply other medical problems like regular pain and infections. If the doctors confirm that the distorted eyelid is causing a real medical issue, the insurance company may cover the surgery.
When it comes for getting a free plastic surgery, the bottom line is: is the surgery medically necessary? In case the required surgery is just for enhancing the regular appearance and is not for repairing or preserving the healthy function of the body, the insurance company may not cover the surgery expenses.
To make sure that the surgery taken place will be covered by the insurance plan, firstly get in contact with the insurer in advance. This mostly means submitting medical records and recommendations by doctors for carrying out the surgery. There are surgeons who are really good in handling insurance coverage for medical surgeries, getting your work done through such a surgeon would make the whole process easier and effective.
Secondly, the details of surgery matters a lot. If the insurer gives a set of rules to be followed during the surgery like how much of mass to be reduced in a breast reduction surgery, they must be discussed with the doctor/surgeon to make sure they are aligned with their practices and solves the medical problem for the patient.
Sometimes, the insurers deny to covering the surgery in the start. This usually happens in cases where the documentation or evidence may seem weak. In this case, appealing the insurers decision can be helpful, along with appealing, provide more medical evidence and recommendations from the doctor to make sure that the insurance company reconsider their decision.
Do you qualify for a plastic surgery? If the conditions of surgery are aligned with the coverage policy of your insurer, to may get the surgery done for free. If the surgical process is on the basis beauty enhancement and fails to provide any sort of medical assistance to your body, getting a free plastic surgery may get difficult.