Across the world,
cosmetic surgeries and implants have been gaining popularity over the years.
However, when you buy a health insurance policy,
you should not expect these expenses to be covered by your insurer. Most of the
health insurance companies would not cover these costs. The words ‘plastic
surgery’ mainly refer to ear and nose jobs, breast enlargements, tummy tucks
and so on. However, implants and cosmetic surgeries may also include several
medical processes, like reconstructive surgery after severe burns and
reconstructive surgery and repairing of cleft palates. While your health insurance
policy might cover some of these, most of them are not covered. You can explore
the online portals to check out the features that the reputed companies offer.
What
is a plastic and reconstructive surgery?
Plastic and
reconstructive surgeries are generally performed to do away with abnormalities.
These might be acquired or congenital, or result from traumas. Through
reconstructive plastic surgeries, the essential medical procedures are referred
to, and not the elective ones. In case you are planning to buy a health insurance
policy, check out whether the insurer provides coverage for any of the common
reconstructive surgeries. While most of the companies do not provide any such
coverage, you might come across insurers who provide these coverages as
add-ons.
Well, you should not
confuse reconstructive surgeries with plastic surgeries and implants. Some
medical insurance companies provide coverage only for reconstructive surgeries,
and not plastic surgeries.
Which surgeries can you actually claim for?
People buying health insurance
policies should be aware of the surgeries that they can actually claim for.
Generally, the insurers provide coverage for:
·
Surgeries as a remedy to serious burns,
like skin graft
·
Surgery for congenital abnormalities
like cleft palate
·
Surgeries for facial reconstruction
after traumatic events
·
Breast reconstruction, if necessary,
after mastectomy
·
Restorative procedures required for the
treatment of scarred skin
Have a look at the
schemes that the reputed companies have designed. You can get a
health insurance policy that covers some of these surgeries. However,
you will not find any such company providing coverage for dental implants or
surgeries for beautification purposes.
What
does your health insurance generally cover?
It may be a nasal deformity or a cleft
palate, that can result in breathing difficulties. Besides, people may suffer
burns, leading to deformities in the skin. Your health insurance scheme
may cover treatments like skin tightening, treatment of scars, skin grafts and
so on. The company may also cover surgeries required for treating traumatic
injuries. This might require facial bone fractures, that you may have to reset
or repair.
Certain surgeries
involve removal or tumors. You might require a skin graft after the removal,
and the insurance company may provide you with the necessary coverage. The health insurance
company may also provide coverage for the repairing of scars.
How
can exclusions and restrictions affect the policyholder?
The medical insurance
policy generally covers all the aspects that are mentioned in the clause. You
can also benefit from other aspects that the policy covers. For instance, if
any reconstructive plastic surgery needs to be performed, the insurance company
may also provide a cover for the congenital abnormalities. Nasal deformities,
cleft deformities and deformities following burns are usually covered by the
insurer. Well, you need to be careful while buying a medical insurance policy, as certain
companies cover all the costs associated with these treatments, while the
others may only provide a partial coverage. However, as a part of the
agreement, the policyholder may have to make a co-payment, or pay an excess.
Other policies may exclude these services, and in return, the premiums will be
lower. Eventually, this might affect the overall coverage that the
policyholders enjoy.
Exclusions of an
insurance policy refer to the services that the scheme does not cover. On the
other hand, restricted services refer to the once, on which the policyholder
can enjoy only a limited benefit. In case you have the exclusions and
restrictions applied to the reconstructive plastic surgery, you may only
partially benefit from the scheme. Therefore, it is recommended to read the
clauses of the medical insurance policy and make the purchase.
Should
you include the reconstructive plastic surgeries in your policy?
Well, in order to save
on health insurance premiums, you may want to exclude the reconstructive
plastic surgeries from the scheme. However, you should remember that the future
is unpredictable and you might end up in a situation, where the doctor
recommends you to undergo one of these treatments. In these cases, you would
require a health insurance policy that provides you with the necessary
coverage. Excluding the reconstructive plastic surgeries from the package may
invite unexpected costs, that you will have to bear from your pocket. The
unplanned expenses will mount, and this might land you up in financial difficulties.
Even if the restricted covers are available, the company might provide a
coverage for only the treatment. In these cases, the other expenses like
hospitalization and accommodation need to be covered. This, too, can lead to
unplanned expenses. Evidently, you should get a health insurance policy that covers all the relevant costs that are likely to arise
in the process.
What
options do you have?
When you buy a health insurance policy, you
have got certain options to manage reconstructive surgeries:
·
Get a comprehensive scheme covering
reconstructive surgery
·
Buy a policy that comes with a
restricted cover for reconstructive surgeries. In this case you need to pay
lower premiums
·
Get a scheme that does not include
reconstructive plastic surgery, but remember that you may have to bear the
expense from your pocket
Now, depending on your
lifestyle and affordability, you should decide whether you should include
reconstructive surgeries in the scheme or not. You may have a consultation with
the insurance company regarding the premiums, if you decide to include the
benefit. It is important to understand the coverage that you need, considering
plastic surgeries. Get across to a reputed
health insurance company and
get a coverage, that can keep you secure.
