Does Health Insurance Cover My Cosmetic Surgery?

September 27, 2023 | By admin

Does Health Insurance Cover My Cosmetic Surgery?

In the last few decades, the Indian medical and pharmaceutical industry has witnessed tremendous growth. This is one of the reasons why the Indian medical industry has become one of the best across the globe. Because of this, there has been significant development in the field of medical tourism.

But still a lot of people in India who might want to get cosmetic surgery shy away from the treatment because of the high costs. There are patients who wonder if plastic surgery is covered under medical insurance to help make the surgeries more affordable. But sadly, that is not the case. Keep reading this blog to find out why.


Medical Insurance Policies: Inclusions and Exclusions

Usually, medical insurance policies are not designed or developed to cover cosmetic surgery insurance or costs. But if the plastic surgery is deemed reconstructive and medically necessary, then the medical expenses incurred due to the surgery can be covered under the health insurance policy.

It should also be noted that the primary reason why cosmetic surgeries are often not covered under health insurance policies is that these surgeries are not deemed necessary to maintain the quality of life or to ensure the right functioning of the body.

There are also some other factors that individuals who are looking to get plastic surgery should be aware of. Keep reading this blog to find out what those factors are and what it would mean for somebody who is planning to get plastic surgery.

Bearing The Cost Of Plastic Surgery

As mentioned above, when it comes to plastic surgery procedures that are not deemed medically necessary, the cost of the procedure will likely be borne by the patient. But this is not the only concern that the patient should have at this point in time.

Instead, individuals looking to get plastic surgery should also be worried about the safety of the procedure. One way to ensure absolute safety while getting plastic surgery done is to get the surgery from a qualified, skilled, and experienced plastic surgeon only. This will ensure that the cost of the procedure is completely worth it as the patient gets the surgery done in a safe and efficient manner.

But what if the surgery you are planning to take is deemed medically necessary? In that case, the cost of the surgery will be covered under the medical insurance. Further, in those cases, these types of plastic surgeries are also known as reconstructive surgeries.

Reconstructive surgery is a medical procedure that is carried out with the aim of correcting physical defects, ailments, and diseases, or correcting physical trauma. This type of physical trauma might be a result of an accident or genetic abnormality.

Reconstructive surgery also usually focuses on normalizing or improving the overall aesthetics of the affected body part or organ. It helps enhance the appearance and functioning of different body parts.

In contrast to reconstructive surgery, plastic surgery procedures are carried out with the aim of beautifying the appearance of the different body parts. These procedures often boost the individual’s self-esteem and confidence.

Most medical insurance policies cover reconstructive surgeries but not cosmetic surgeries even though both of these types of surgeries are carried out by the same type of medical practitioners.


Under Which Conditions Does Medical Insurance Cover Plastic Surgery?

We have mentioned above that reconstructive surgeries are covered under medical insurance policies. But individuals should also be aware that the coverage of plastic surgeries under health insurance policies is also dependent on the criteria of the provider.

In order to understand this criterion and whether the process is covered under medical insurance or not, it is important to evaluate if:

  • The surgery is cosmetic or not
  • The process is reconstructive or not
  • The surgery is life-saving or not

In most cases, if the process is life-saving or reconstructive, the medical expenses incurred are covered under the health insurance policy. But do you want to make sure whether your health insurance provider gives coverage for plastic surgeries or not?

In that case, you should directly reach out to your medical insurance provider and raise a request to understand the nuances of the coverage. And if your medical insurance policy covers reconstructive plastic surgery procedures, then some common plastic surgeries that are covered under your policy are:

  • Surgery for normalizing congenital anomalies
  • Repair of cleft palates
  • Repair of cleft lips
  • Repairing nasal deformities that cause difficulty in breathing
  • Scar repair
  • Laceration
  • Surgeries for normalizing traumatic injuries
  • Surgeries for normalizing damage caused due to incidents of burns like grafting, skin tightening, and reconstruction
  • Surgeries followed by treatment of tumors or cancer

Can I Upgrade My Plan To Cover Plastic And Reconstructive Surgeries?

In most cases, it is possible for individuals to upgrade their health insurance plans to include reconstructive surgeries if it’s not already covered. However, even in those cases, there is usually a waiting period of 12 months before one can avail of treatment for pre-existing medical conditions or ailments. But this waiting period can vary from one insurance provider to another.

What Should I Do If My Health Insurance Does Not Cover My Cosmetic Surgery?

If your health insurance does not cover cosmetic surgery and you still wish to get one, then we at Divine Cosmetic Surgery offer patients several, flexible payment plans that can be availed. On top of this, Divine Cosmetic Surgery is also famous for providing patients with affordable treatment options.

At Divine Cosmetic Surgery, we have one of the best teams of medical experts in India. We excel at providing patients with high-quality cosmetic surgery done with 100% safety to ensure amazing results.

If you want to know more about our affordable plastic surgeries or flexible payment plans, book a consultation with us today!