Know are Cosmetic Surgeries Covered under Health Insurance Policies?

Avni (21-years-old) works as a freelance model for various fashion and jewelry brands. Avni purchased a health insurance policy that will safeguard and offer her financial assistance during any healthcare emergency. But to make a scintillating career in this fashion world and explore more opportunities, Avni plans to do a facelift cosmetic surgery that will enhance her beauty and self-esteem. But Avni is not sure whether her health insurance policy will support her cosmetic surgery treatment or not.

Not only Avni but also many others who want to perform cosmetic surgeries to enhance their appearance and physical attributes may not have adequate knowledge of whether their cosmetic surgery insurance plans will support their treatment or not.

These days, the popularity of cosmetic surgeries is rising exponentially. But unfortunately, these treatment procedures are quite expensive and will make a hole in your pocket. The cost of cosmetic surgery includes the consultation fees of the surgeon, pre-medical sessions, the cost of implants, OT room charges, post-operative costs, anesthesia, medications, and maintenance costs.

Though many people in India want to perform these surgeries due to their professional commitments, they are hesitant because of high costs and exclusion in various health insurance policies. Moreover, since these cosmetic surgeries are mostly elective, most health insurance policies don’t cover the costs of these treatments.

Does insurance cover cosmetic surgery?

Cosmetic surgeries are not considered vital medical procedures that are required to protect the life of a person. That’s why any health insurance does not cover these.

When you are planning for cosmetic surgeries, the prime thing that crosses your mind is the procedure’s cost and safety. Depending on the provider and your plan, the cosmetic surgery you plan will be covered under the health insurance policy. At the time of your claim process, health insurance companies will check whether the process was cosmetic or reconstructive surgery.

The two popular cosmetic surgery treatment methods below are many resemblances yet are quite diverse from each other.

Cosmetic Surgery: Cosmetic procedures are performed by experts to refurbish the appearance of a particular part of your body. These procedures augment the patient’s appearance and confidence.

Reconstructive Surgery: On the other hand, these surgical treatments are conducted to overcome trauma, physical impairments, diseases, or ailments. The prime reasons for physical trauma are an accident or genetic abnormality. Usually, these treatment procedures enhance the affected body part’s overall aesthetics and normalize its functioning and appearance.

Most healthcare policies cover reconstructive surgeries, but not cosmetic surgeries. Yet, both of these two processes are performed by the same medical experts.

If the doctors recommend reconstructive surgeries, then all types of procedures and claims are covered by health insurance policies. Doctors generally recommend reconstructive surgeries to normalize congenital incongruities, including the repair of cleft palates, cleft lips, nasal deformities that cause trouble while breathing, and so on. Reconstructive surgeries are also performed to normalize traumatic injuries, burn marks, scar repair, etc.

When Does The Policy Cover Plastic Surgery?

Depending on your criteria of treatment and the medical procedure, your health insurance policy will compensate for the cost of your plastic surgery treatment. To decide and understand whether the treatment procedure will be covered by your health insurance policy, it is imperative to make out if,

• The process is reconstructive
• The process is life-saving
• The process is cosmetic

If the treatment procedure is reconstructive or life-saving, then all your treatment expenses will be covered by health insurance policies. However, to understand your policy’s coverage in a better way, you must get in touch with your insurance company with all the details of the cosmetic treatment process. This will help you to understand all minuscule clauses of the coverage.

If your policy covers both plastic and reconstructive surgeries, it will reimburse for some common procedures.

• Surgeries need to conduct as a result of burn such as grafting, reconstruction, skin tightening
• Surgeries are carried out to normalize congenital irregularities like repairing bifurcated lips, cleft palates, nasal deformities that cause problems during breathing, etc.
• Reconstructive surgeries for shocking/ traumatic injuries
• Laceration
• Scar repair
• Surgeries after the treatment of tumors or cancer

Does insurance cover skin treatment?

Most health insurance policies in India are used to reimburse the costs for the treatment of dermatology or skin problems. If you purchased a health insurance policy from an eminent insurer, then you can initiate a claim to cover your treatment costs for dermatological/skin problems. Skin cancer treatment costs will be covered by a critical illness insurance policy as well as by a cancer insurance policy.

But the coverage may vary from insurer to insurer as most policies usually cover hospitalization expenses for your dermatological treatment or surgery. They may exclude OPD consultation fees and daycare treatment procedures. Some policies may cover all expenses, including hospitalization costs, daycare treatment costs, and OPD charges.

Types of dermatology treatment procedures that are covered by health insurance plans

• Skin cancer treatment
• Acne
• Skin cancer surgery
• Rashes
• Skin fungal infections
• Reconstructive surgery
• Skin allergies
• Poison Ivy rash
• Keloid scars

Does insurance cover keloid removal?

Keloids are unappealing, distracting, and very painful. As a result, many people are looking for keloid removal treatments. Unfortunately, if you want to get rid of your keloid scars for cosmetic reasons, your insurer may not cover the costs of treatments. On the other hand, if it is mandatory for medical purposes and recommended by a doctor, then your insurer may cover the whole or portions of the treatment costs.

Since the demand for cosmetic surgeries is increasing, many insurers are offering various lucrative plans to customers. Therefore, if you plan to purchase skin removal insurance plans, you must compare, shortlist, and analyze multiple insurance plans and choose the best one per your requirements.