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Does health insurance cover plastic surgery?

Few medical insurances cover plastic surgery, since, on the one hand, its cost is very high and, on the other, it is not generally considered a first-need surgical intervention. On the contrary, the vast majority of insurances do take care, instead, of the so-called repairing or reconstructive surgeries.

Therefore, when defining Urgent health insurance coverage, it is crucial to determine if a specific surgery is restorative or purely cosmetic. In most cases the difference is very clear, but there are cases where it is not so easy to determine the limits that separate one or another surgery, especially when the aesthetic appearance influences other pathologies of a psychological nature. Hence the great importance of knowing the coverage of your health insurance well, in order to avoid confusion and surprises afterwards.

Differences between cosmetic surgery and reconstructive surgery

Aesthetic surgery and reconstructive surgery are the two great branches of plastic surgery. The differences between one and the other lie mainly in the reason why the intervention is carried out. Thus, in the case of cosmetic surgery, operations are performed only because the patient wants to improve the physical appearance of certain parts of his body or combat the effects of aging. This is the case, for example, in operations to correct the shape of the nose (rhinoplasty), perform breast augmentation or reduction, liposuction or hair grafts, among others.

For its part, restorative or reconstructive surgery focuses above all on correcting those negative effects on the body that occur as a result of accidents, injuries, diseases or various anomalies. It is, therefore, about problems that constitute authentic medical pathologies, which implies that the purpose of this surgery is not merely aesthetic, but to achieve an improvement in the patient’s health and quality of life.

Insurance that covers plastic surgery operations

Certain plastic surgery operations may be included in the most comprehensive medical insurance coverage. Of course, for this to be the case, companies usually require that the purpose of the intervention be reconstructive and not purely aesthetic.

However, although insurance companies do not cover cosmetic surgery itself, some do offer discounts and very advantageous prices to those insured who wish to undergo this type of intervention. In such cases, they also tend to provide them with easy access to tables of medical professionals specialized in cosmetic surgery operations.

What type of plastic surgery is usually covered by health insurance?

As already mentioned, the insurance policies that cover plastic surgery operations do not include interventions for purely aesthetic purposes, although they do include reconstructive or repair surgery. This category would include, among others, the following surgical interventions:

  • Tissue grafts to improve injuries and hide scars resulting from accidents or burns that seriously affected the skin.
  • Breast reconstruction operations after a mastectomy.
  • Those necessary to repair areas of the body affected by the treatment of certain tumors.
  • Those aimed at correcting external damages or losses caused by other previous operations.
  • Interventions to repair congenital anomalies, such as cleft lip, breast asymmetries, facial or limb malformations, etc.

In any case, for the insurance to cover the expenses associated with these interventions, the injury or anomaly must have been diagnosed once the patient was already insured. Thus, if you take out health insurance after said diagnosis, it is normal for the insurer not to take charge of the coverage.

Take out tailored health insurance

Before taking out medical insurance, you should find out in depth about the coverage it offers you and, above all, that these are adjusted to your real health needs. Consider that, although aesthetic interventions are not included in the policy, many companies do bear the cost of those plastic surgery operations that are necessary to correct a congenital defect or the physical sequelae derived from certain accidents, injuries or illnesses.

In any case, before hiring your health insurance, it is worth making an exhaustive comparison between the policies offered by the main insurance companies. To do this, we recommend using the doctori.com medical insurance comparator. It is a fast, efficient and certainly easy to use comparator. Thanks to Doctor i you will be able to find the most suitable health policy for you —with all the coverage you need— and pay the right price for it.

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