Check Does Health Insurance Cover Cosmetic Surgery?
Are you considering getting cosmetic surgery? Well, you are not alone. In fact, around 8 to 10 lakh cosmetic surgeries are performed in India every year.
A major misconception that many people have is that health insurance will cover their cosmetic surgery expenses. The truth is that it doesn't. While health insurance covers the expense of various types of surgeries, cosmetic surgery isn’t one.
A simple reason behind this is that cosmetic surgery isn’t a necessity for any individual. These surgeries are generally done in order to enhance an individual’s appearance. As it is a personal choice, health insurance plans do not consider cosmetic surgery as a medical necessity. Hence, no health insurance coverage is provided.
Curious to know more? Read on to this blog to find out in what cases your health insurance will pay for your surgery and much more!
But before diving directly into the main question, let’s first understand how much cosmetic surgery may cost in India.
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Cosmetic Procedure Cost
To tell the exact cost of a cosmetic procedure is quite a hard task. After all, there are several factors that influence the cost of cosmetic surgery :
- The type of procedure being followed: Different cosmetic surgery procedures have different fees.
- The surgeon’s experience and location: Obviously, India’s top doctor charges more. Moreover, hospitals in tier 1 locations charge relatively higher.
- The facility where the procedure is performed: The bigger the hospital’s name, the more they’ll charge. Of course, for the facilities and services they provide.
- Any additional fees: Along with the surgery cost, there are other associated costs for anaesthesia, medication, or aftercare.
For instance, if your cosmetic procedure includes a few simple Botox injections, it will only cost you something from around ₹15000 to ₹25000. On the other hand, if you are going through a facelift surgery, it can cost you up to ₹2,00,000 or more.
Difference Between Cosmetic and Reconstructive Surgery
While many think that cosmetic surgery and reconstructive surgery are the same, there’s a major difference. Both these surgeries serve different purposes.
Cosmetic Surgery, simply saying, is altering/enhancing one’s body appearance through surgery. This surgery is generally done in order to improve the aesthetics of one’s body. Some popular examples of cosmetic surgeries include
- Breast augmentation
- Rhinoplasty
- Liposuction
- Eyelid surgery
On the other hand, reconstructive surgery is done in order to correct the appearance after an injury, disease, or birth defect. The major reason behind this surgery is to improve a patient’s quality of life medically. Common examples include
- Repairing facial trauma
- Reconstructing breast tissue after mastectomy
- Correcting congenital anomalies
All in all, the major factor that differentiates cosmetic surgery and reconstructive surgery is the necessity and intent of surgery. Needless to say, the intent behind these surgeries may overlap in some special cases.
When Does a Health Insurance Policy Cover Cosmetic Surgery
Typically, health insurance isn’t responsible for covering the cost of cosmetic surgery as it’s mostly a personal choice and not medically necessary. However, there may be some other surgery cases in which your health insurer agrees to pay the insurance coverage.
A medical necessity can be categorised into three major types:
- Reconstructive Surgery: If the surgery can significantly improve the quality of life and help one recover from a trauma or health complication, health insurance coverage can be availed. For example, getting breast reconstruction surgery after a mastectomy.
- Functional Improvement: In such cases where surgery can improve a person’s body functionality, insurance may cover it. For example, some policies might cover rhinoplasty (nose surgery) if it is necessary to improve breathing due to a deviated septum.
- Grey Areas: There are certain cases when a surgery may fall into a grey area between cosmetic and medical. In such cases, health insurance coverage may be given based on the patient’s condition. For example, eyelid surgery may be covered if it's performed to correct drooping eyelids, improving a patient's vision.
Health Insurance Companies Offering Cosmetic Surgery Coverage
As straight as it sounds, there are currently no health insurance companies that provide cosmetic surgery coverage.
However, if you seek reconstructive surgery, here are a few health insurance providers that may provide coverage:
Conclusion
There you have it – A comprehensive guide to clearing all your doubts regarding health insurance coverage for cosmetic surgery. We certainly hope that this blog helped you understand the difference between cosmetic surgery and reconstructive surgery. If you are thinking of having cosmetic surgery and want your health insurance cover to help pay the expenses, it's highly recommended to consult with your healthcare provider and your insurance company. Only they will be able to confirm if your health policy covers the procedure you are interested in.
Until next time!
Frequently Asked Questions
Ques 1. Why is cosmetic surgery not covered by insurance?
Ans. A simple reason behind health insurance not covering cosmetic surgery is that it is not a medical necessity. Often, it is just a personal choice in order to enhance appearances.
Ques 2. Does Medicare cover skin removal surgery?
Ans. Generally, a skin removal procedure is considered cosmetic surgery and isn’t covered by health insurance. However, if you can present doctor testified documents that can prove the skin removal surgery is a necessity, the insurer may consider health coverage.
Ques 3. What major factors affect cosmetic surgery cost?
Ans. Several factors affect the cost of cosmetic surgery:
- The type of procedure being followed
- The surgeon’s experience and location
- The facility where the procedure is performed
- Any additional fees for anaesthesia, medication, or aftercare.
Ques 4. Does health insurance cover reconstructive surgery?
Ans. Yes. As reconstructive surgeries are a necessary medical procedure that improves the quality of life of a person, a health insurer may provide expense coverage.
Ques 5. How much does cosmetic surgery typically cost in India?
Ans. Determining the exact cost of cosmetic surgery in India is not possible as there are many factors that influence it.
For example, if your cosmetic procedure includes a few simple Botox injections, it will only cost you something from around INR 15000 to INR 25000. On the other hand, if you are going through a facelift surgery, it can cost you up to INR 200000 or more.
