5 Cosmetic Procedures Your Insurance May Cover

K. Mathews on 3 Jan 2012 at 3:30pm

Cosmetic procedures are not cheap, so wouldn’t it be nice if insurance covered the cost for you? Though few and far between, there are some cases when a doctor can identify a legitimate medical problem that necessitates the procedure -- obligating your insurance to chip in.

Here are 5 procedures that insurance may cover -- along with what they will and won't pay for.

1. Nose Jobs

WILL: Insurance tends to cover septoplasty for patients with a deviated septum that disrupts breathing so long as the problem is documented by your doctor.

WON’T: Any aesthetic changes to the nose (rhinoplasty) are not covered. Many patients still pursue both procedures simultaneously, and the doctors simply bill the septoplasty to insurance and the cosmetic portion to the patient explains Dr. William Portuese.

2. Breast Reduction

WILL: Many insurance companies will cover the procedure, but they don’t make it easy, explains Dr. Christopher L. Hess. Often patients must visit their primary care doctors to establish back, neck, and shoulder pain, and first try physical therapy.

WON’T: Small downsizes will not be taken seriously. “About a pound of tissue” from each breast must be removed for insurance to consider it necessary warns Dr. Richard P. Rand.

3. Weight-Loss Surgery

WILL: Insurance companies pay for many morbidly obese patients to have gastric bypass surgery, though this approval typically follows a psych evaluation and year of supervised diet and exercise according to Dr. Mark Pleatman.

WON’T: Good luck dealing with the costs of getting rid of excess skin following weight loss. Liposuction and tummy tucks are considered cosmetic in nature and are rarely covered by insurance.

4. Eyelid Surgery

WILL: If droopy skin around your eyes is interfering with your sight, insurance will often cover the procedure provided tests show it will improve your vision says oculoplastic surgeon Dr. Kami K. Parsa.

WON’T: “Insurance companies never cover the lower eyelid belpharoplasty,” adds Dr. Parsa.

5. Invisalign

WILL: “Dental insurance policies that have an orthodontic benefit provide coverage without limiting it to a specific type of braces,” says orthodontist Dr. R. William McNeill. Since Invisalign is one way of achieving straighter teeth, it counts.

WON’T: Orthodontist Dr. Doug Depew cautions that insurance companies reimburse about 50% of the cost when it comes to orthodontics, so be aware that a lot of that ~$5000 procedure may come from your own pocket.