Quick Insurance Facts on Plastic and Reconstructive Surgery

Plastic and Reconstructive Surgery

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Plastic and reconstructive surgery may be two different areas of medical specialty but both aims to make one look good.  Plastic surgery is more focused on treating any type of either acquired or congenital physical deformity. Today, plastic surgery is a famous procedure for anyone who is in good state of health who simply wants to improve their appearance and fight off signs of aging.

Reconstructive surgery, on the other hand, is commonly done to improve function. For example, the nose may be reconstructed to improve one’s breathing or smelling capabilities. However, nowadays, both plastic and reconstructive surgery can be carried out to depending on the patient’s wishes. Granted that the patient knows the limitations of both plastic and reconstructive surgery and is financially capable, the plastic surgeon may make it happen.

Is It Shouldered by Insurance?

Unfortunately, most of the plastic and reconstructive surgery procedures are not recognized by Medicare or other health insurance partners as these are deemed to be not a matter of life and death procedures. Exemptions, however, may be feasible if the patient can prove that he/she does need either the plastic or reconstructive surgery procedure to improve his overall health.

Here are some of the known exemptions/exclusions where your insurance might still cover for your plastic and reconstructive surgery costs:

  • Congenital abnormalities that can cause health problems such as cleft palate or lips and nasal deformities.
  • Accidents such as burns or lacerations that may cause undue damage not only to the physical appearance but emotionally as well.
  • Traumatic injuries especially if it happened during the time of work.
  • Plastic and reconstructive surgery need that arises from a cancer or tumor removal.

Remember that these are just examples and it would always depend on a certain clause in the insurance policy agreement one have signed. This is why it pays to fully read every sentence in any insurance agreement especially for those who might be concerned with plastic and reconstructive surgery.


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