Does My Health Insurance Cover Cosmetic Procedures?


Studies have found that cosmetic procedures improve self-esteem and boost confidence. Generally, most people who have procedures say that the experience is a positive one in their lives. However, for various reasons, your health insurance plan may or may not cover the procedure you are considering, depending upon the reasons you are considering the surgery.

Understanding “Medically Necessary”

Everyone’s health insurance policy is different and it is absolutely vital that you understand the all of the terms of your specific contract with your insurance company before you undergo medical care. However, in general, most health insurance plans only cover or partially cover procedures and treatments that are deemed medically necessary.


Medically necessary treatments are officially deemed, “health-care services or supplies needed to prevent, diagnose, or treat an illness, injury, condition, disease, or its symptoms and that meet accepted standards of medicine.”


Said more simply, if your procedure isn’t treating a specific health problem, then it is probably not covered by your insurance.

Procedures That May Be Covered By Insurance

Although many cosmetic procedures are not covered by health insurance plans, you may be surprised that some procedures that are not traditionally covered by insurance may be in certain cases. Here are four common examples:



  • Reconstructive Surgery. If your surgery takes place after an accident that caused scarring or deformity (such as a traffic accident, assault, dog bite, or burn), and if the surgery is specifically meant to fix that health issue, your insurance likely covers some or all of the bill. Likewise, if you were born with a health issue such as congenital birth defect, reconstructive surgery to correct that issue is likely covered.




  • Nose surgery (Rhinoplasty). Many people assume that “nose jobs” are purely cosmetic, but that is not always true. If a rhinoplasty takes place to fix a deviated septum that makes it difficult to breathe or sleep, it may be covered. In addition, if your nose has been malformed from an accident or was malformed by birth, you may be covered.




  • Eyelid Surgery (Blepharoplasty). Eyelid surgery is often associated with looking younger and more alert. However, drooping skin around the eyelids can actually significantly affect your vision. If you have eyelid surgery in order to improve your sight, it may be covered by your insurance.




  • Ear Surgery (Otoplasty). Ear pinning and other types of ear surgery are often covered by insurance, if you can establish that you either were born with protruding ears or that your ears were harmed in an accident.



The best way to know if your surgery or procedure will be covered by your health insurance policy is to read your policy closely and to call your insurance company. In addition, speaking to your doctor and the team at the Surgical Arts Centre can help you better understand your situation and your options for payment.

Contact The Surgical Arts Centre In Missoula, Montana

Whether you need a procedure that will help you with a disease, illness, or health condition, or whether you are looking for a purely cosmetic procedure to improve your life, we are here to help. To learn more about the procedures we offer, to ask a question, or to schedule a consultation, please call us today at (406) 549-6600.

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