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Will Insurance Cover My Procedure?
Unfortunately, there is no straightforward answer to this question as every insurance plan will define “medically necessary” a little differently. Often, if a condition has a major impact on your daily life, it is considered medically necessary and should be covered by insurance. Examples of this may include daily back and neck pain due to large breasts, drooping eyelids that hinder a person’s ability to see well, or breathing issues due to a deviated septum.
Plastic surgery is divided into two main categories – reconstructive plastic surgery and cosmetic plastic surgery. Reconstructive plastic surgery is typically covered by insurance, while cosmetic plastic surgery is not.
Reconstructive plastic surgery is performed to treat body parts affected either aesthetically or functionally by congenital defects, defects caused by disease and defects caused by injury or trauma. Examples of reconstructive plastic surgery include breast reconstruction, facial reconstruction, hand or nerve reconstruction, Mohs reconstruction and skin lesion or cancer removal. Typically, reconstructive plastic surgery is considered medically necessary and is covered by most insurance plans.
Cosmetic plastic surgery is the reshaping of normal structures on the body to improve someone’s self-esteem or physical appearance. Examples of cosmetic plastic surgery include breast augmentation, breast lift, liposuction, abdominoplasty (tummy tuck), and facelifts. Since cosmetic plastic surgery is not medically necessary, insurance will not cover these procedures.
Please keep in mind that this is only a general guide on what may and may not be covered by insurance and you will need to speak with your individual insurance provider to see what may be covered for you.
At The Center for Plastic Surgery at Sentara Princess Anne & Fort Norfolk, we understand that health insurance does not cover most cosmetic procedures and they can be quite expensive to pay out of pocket. In order to make your procedure more affordable, we have partnered with CareCredit and PatientFi for individual plastic surgery financing options. Click below to learn about each option and to apply for financing. We also accept all major credit cards. For any questions, feel free to contact us.