Insurance for ER visits related to breast augmentation?

Question

I understand that ER visits and hospital stays related to breast augmentation are very rare. However, insurance for such an emergency situation would give me peace of mind. What should I look for in an insurance plan? Has anyone had experience with CosmetAssure?

Christopher Pannucci, MD, MS · Answer

Hi Nurturing407799,
Your question is excellent. Complications in breast augmentation are fortunately rare, but you are correct that most insurance programs will not pay for downstream complications of aesthetic surgery. 
CosmetAssure is a cosmetic surgery insurance program, purchased at the surgeon level, not the patient level. This means that a participating surgeon elects to purchase the policy for all of his or her cosmetic surgery patients--this avoids surgeons "cherry picking" and purchasing the insurance only for their higher risk patients.
I purchase a CosmetAssure policy for all of my patients. Fortunately, I rarely have to submit a claim for a complication, but it is a wonderful peace of mind for both patient and surgeon, in the rare instance that a cosmetic patient needs an ER evaluation or a hospital admission.
The attached video link describes recent data on complications in breast augmentation surgery, which is relevant to your question.
Hope this helps.
Best,Christopher Pannucci MDBoard Certified Plastic Surgeon Plastic Surgery NorthwestSpokane, Washington

Brian K. Reedy, MD · Answer

Hi & thanks for your question.
You would need to contact several insurance companies to find out if this would be a covered benefit under specific plans. Best wishes!

Justin Perez, MD · Answer

Great question. 
Insurance policies for elective cosmetic surgery, while not always required by your surgical provider, are an excellent option. I have had patients get and use CosmetAssure policies, even if its infrequent. It's a great program that, as you mentioned, can give patient peace of mind around the time of elective surgery. Any kind of surgery and anesthetic event, including with aesthetic surgery, inherently carries risk with it. Even if in the best of hands with optimal planning and risk reduction, medical and surgical complications can and do occur. The great part about CosmetAssure is if around the time of surgery you and your provider are remotely concerned that something else is going on, you can be evaluated and get it taken care of expeditiously without taking on the additional stress of worrying how you will pay for it, etc. Safety around the time of surgery is paramount. I've never had a patient come back to me saying the wish they hadn't gotten CosmetAssure. However, I have had patients say that they were glad they did get it. Hope that helps!
Have a great weekend!Dr. Perez

Camille Cash, MD · Answer

You are correct that ER visits after breast augmentation would be very rare.  Complications that arise should be discussed with your surgeon.  When  shopping for a policy you want to consider coverages, facilities that are in your network, as well as out of pocket costs in addition to premiums.

Connie Hiers, MD, FACS · Answer

You can buy a specific policy, like CosmetAssure, for your breast augmentation to cover any unexpected medical expenses. Your surgeon can discuss this with you.

Joshua B. Hyman, MD · Answer

If you develop a hematoma after breast augmentation (essentially the only emergency that can happen) the ER visit will be covered by your insurance company, The coverage depends on having good private coverage such as blue cross or oxford. Your surgeon should feel comfortable addressing most emergencies at his/her office. I recommend you discuss with your surgeon what they would do with a hematoma and why they would send you to an emergency room instead of taking care of you in the office and private surgical center. I do not charge the patient for emergencies, and it is worth asking your surgeon what their policy is. CosmetAssure is worthless unfortunately. Your best insurance is trusting your surgeon to do the right thing.

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