Who Pays for the Cost of Emergency Room After Surgery if It Becomes Necessary?

Hello! Thank you for your question! Surgical procedures for aesthetic
purposes, to improve appearance, are not covered by insurance.
Typically, these as well as complications resulting from such procedures
are the responsibility of the patient. Procedures that are meant to
correct functional issues and those which cause health-related issues
should be covered by your insurance as a medical necessity, with proper
examination and documentation. Some insurance plans have exclusion
criteria for certain procedures. Also, it is an obligation of the
surgeon not to attempt to authorize purely cosmetic procedures through
insurance.  This is often true, depending on the reason for the visit or surgery.  You should discuss this with your insurance prior and clarify.  Discuss your issues and
complaints with a board-certified plastic surgeon to discuss these as
well as to examine and assist you in deciding which procedure(s) will be
the best for you. A discussion of the advantages and disadvantages will
take place along with the risks and benefits. Insurance companies will
vary on coverage and is always reasonable to discuss your issues with
your surgeon and primary care. It would behoove you to get as much
information as possible and even call your insurance yourself.
Certainly, pay in advance prior to your surgical procedure and options
such as financing are available if you qualify. Hope that this helps!
Best wishes!

Complications following cosmetic plastic surgery is extremely rare when performed by a Board certified Plastic Surgeon. Most health insurance companies will not cover the cost of ER visits from cosmetic surgery. We offer all our patients CosmetAssure to give everyone the peace of mind about their cosmetic surgery. However, if you are considering cosmetic surgery, make sure that your Plastic Surgeon is a “real Plastic surgeon”. There is a huge difference between Plastic Surgeons and Cosmetic Surgeons. Do your homework you sign the contract. 

Although this is very unlikely, I've heard of it happening and yes, you would likely be responsible for your bills.

Be informed that there are companies, CosmetAssure is one example we carry, that provide insurance specifically for the procedure you are having.  It's a one-time fee paid at the time you sign up for surgery and covers you in case there are problems.

It's like purchasing travel insurance, you don't think you are going to get sick or injured in a foreign land; but if you do, aren't you really glad you bought it instead of being stranded in Timbuktu.  (No offense intended to the kind residents of Timbuktu, Mali. Yes, it is a real place).

I hope this helps.

It is so rare, it probably is not worth worrying about!! In almost 20 years of practice, I have never had one patient that needed the ER after Breast Augmentation. And as has been suggested, always call your surgeon before going to an ER...And some insurance companies will cover emergencies, just not anything elective...But you really should not need it....

Hi there-

The information you have been given so far is accurate- health insurance carriers will not cover the costs of complications arising as a result of cosmetic surgery, no matter the severity of the complication.

Some surgeons do offer Cosmetassure, which is essentially insurance that does cover these problems, but it also increases the costs of your surgery...

The best way to protect yourself from unwanted complications and unplanned expenses is to choose your surgeon in the very most careful way possible. Ask how often (if ever) they have patients need unexpected medical care, if a patient has ever needed an ER visit, etc... For an experienced, skilled surgeon, these occurrences should be extremely rare. 

This is, unfortunately, another example of one of the many reasons you do not want to make the mistake of believing that we are all created equal and you should therefore shop for the lowest price. Your happiness and safety (not to mention your money) depend on you finding the best, most experienced, talented, and ethical surgeon you can. 

Many plastic surgeons participate with a company called CosmetAssure that will provide coverage for certain common complications that occur after cosmetic surgery. 

You should inquire about this type of program and consider this as one factor in choosing yoiur surgeon.

Everyone's health insurance policy is different, however, in general, most health insurance plans do not cover any complications resulting from a cosmetic procedure. You have to read the fine print of your individual plan. It doesn't hurt to try and bill health insurance since they do cover these issues sometimes. However, there are very reasonable priced cosmetic insurance plans that can be purchased prior to your cosmetic procedure that cover complications resulting from the cosmetic procedure. Your plastic surgeon can give you information on these plans that are sold by a separate company. You can also ask your plastic surgeon if you are at increased risk of having a complication and thus worth the extra expense of obtaining the policy. Best wishes,Pablo Prichard, MD

Going to an emergency post breast augmentation is rarely needed.  In 30 years of practice, we have had one patient go and that was from anxiety.  Each office would handle this situation differently. In our case, we worked with the hospital to waive the fees.

The likelihood of a visit to an ER is very low following a breast augmentation. However, should this occur, the costs can be significant. You have done the appropriate first steps by contacting your insurance provider to see if they cover the costs. There are separate insurance companies which will provide term limited coverage for cosmetic procedures. CosmetAssure is one company that provides this service. Ask your plastic surgeon about this prior to having your procedure done.

Fortunately, hospital treatment after elective breast surgery is rare, especially if you go to qualified plastic surgeon who has been diligent in screening you from a health standpoint for your upcoming surgery. However, emergencies can happen and it will be difficult to predict whether or not a post operative ER visit or hospitalization would be covered by your insurance company. There is a company that provides insurance for complications after cosmetic surgery if the complication occurs within 30 days of the procedure. This company is called CosmetAssure and would be a company that your surgeon contracts with. You may want to consider choosing a plastic surgeon who offers CosmetAssure on the rare chance that you would need ER treatment after surgery.