Is cosmetic surgery and implants covered in health insurance? - An online health& Fitness Blog to know more about health, fitness & food.

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Is cosmetic surgery and implants covered in health insurance?

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.
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