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Will Health Insurance Cover Your New Look?

doctor2 It’s hard to think of a scenario in which getting calve implants would be considered a necessary medical course of action. Cosmetic Surgeries are elective procedures, meant to enhance your life, not save your life. Therefore, health insurance providers typically will not cover cosmetic surgery. However, there is some gray area to explore on this topic.

Try to get the vision of Joan Rivers out of your head. Elective surgeries are not solely comprised of face lifts and tummy tucks. Elective procedures also include surgeries like hysterectomies, cataracts, vasectomies and tubal ligations.

When deciding whether or not a surgery will be covered, health insurance companies determine whether or not the procedure was medically necessary. The answer is not always cut and dry. Consider these examples:

    Rhinoplasty (nose job): This procedure is not only done to correct an unfortunate honker. Rhinoplasty is often recommended by physicians to correct breathing problems. Commonly, patients will be diagnosed with a deviated septum and rhinoplasty is the recommended treatment. It is likely that this surgery could be covered by insurance because if gone untreated, serious complications and infections may occur down the road.

    Breast reduction: This isn’t always a vanity thing, either. Over time, large breasts can cause severe back, neck and shoulder damage. If a woman has strong, documented reasons for needing a reduction, a health insurance company usually will agree to cover it. Again, it can be seen as a preventive measure that will cost the insurance company less money in the long run. Still, expect sessions of physical therapy before surgery is considered necessary.

    Hip Replacement: Okay, so nobody gets a new hip because they want to rock a curvier silhouette. Yet, this procedure is still technically considered elective. That said, orthopedic surgeons recommend hip replacement surgery to greatly improve a patient’s quality of life. While it may not be an emergency procedure, health insurance companies realize that the pain and discomfort associated with a bad hip can make it fall into the necessary category.

These are only a sampling of so-called elective surgeries that may be covered by health insurance. As always, here at GoHealth we believe that an informed decision is the best decision. Ask your health care and health insurance providers plenty of questions before undergoing any surgery, elective or not.

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