TomorrowMakers

Does insurance cover the cost of my cosmetic surgery? This piece will answer your query.

Is cosmetic surgery covered by insurance?

Cosmetic surgery is an elective surgical procedure carried out on someone as a result of a choice made by them. It is usually done to improve the appearance of the person by making alterations in a specific body part; by surgically removing, reshaping, or tightening it. Tummy tuck, breast implant, nose job, and liposuction are some common examples. 

Plastic surgery can be of two types: reconstructive and cosmetic. While cosmetic plastic surgery is voluntarily undertaken to alter a person’s appearance, reconstructive surgeries reconstruct or improve the functioning of a body part. Surgical treatment of burns is an example of the latter.

Related: 5 reasons your car claim gets rejected 

Is cosmetic surgery covered by insurance?

The difference between reconstructive and cosmetic surgery is essentially the difference between need and want. The reconstruction of a body that has suffered a burn injury is a necessity – without this, not only would the person's appearance be affected, it would also hinder the efficient functioning of the body parts and blood vessels. On the other hand, a nose job may make the nose more pleasing but doesn’t improve its functioning in any way. 

There are surgeries that are slightly more difficult to categorise, such as bariatric (obesity-reducing) surgery. The Medical Council of India has confirmed that it falls under surgical gastroenterology and is not a cosmetic procedure. However, it is a subject of frequent dispute between insurance companies and the insured.

Related: Why Insuring your Health is a Smart Decision? 

Insurance companies reject most claims against bariatric surgery by saying it is for a cosmetic purpose. But what if an overweight person who was advised to undergo bariatric surgery didn’t do so due to lack of support from the insurance company; and subsequently gained more weight and developed issues like diabetes? In hindsight, bariatric surgery when recommended by a physician can be seen more as a reconstructive surgery than a cosmetic one.

However, if customers refuse to blindly accept such rejections and instead challenge them in court, insurance companies often end up eating humble pie. The Maharashtra State Consumer Disputes Redressal Commission had once rejected the contention of an insurance company that eye correction surgery is cosmetic. 

Even a surgery that prima facie seems cosmetic may still get insurance coverage if there is a medical condition attached to it. For example, nose jobs have been done by people who have a deviated septum (a structural defect). Whatever the interpretation, it is well established that insurance companies heavily discourage insurance claims for cosmetic surgeries.

Related: Features of new age health insurance plans in India: innovation and ease 

Going solo with a cosmetic procedure

If we exclude Mediclaim from the purview of cosmetic surgery, it becomes an expensive affair that can make one think twice. We have to understand that a person prepares to go under the knife only after deep consideration about the consequences on not just their appearance but their bank balance as well. 

After so much mental preparation and building hopes of a better appearance, it is quite unfortunate if the person has to drop the plan due to its exclusion from medical benefits. However, those who value the importance of a cosmetic surgery in their life can rejoice – there is financial assistance available that can make their dreams come true!

Related: Eight health insurance myths debunked

Financial support for surgical purposes

A personal loan is a great solution for anyone looking for financial support to meet medical expenses. Although cosmetic surgery is rarely an emergency, it is reassuring to know that in cases where an insurance claim is rejected at the last minute. 

Cosmetic surgery can be a long-cherished dream for many and it shouldn’t be dashed due to rejection from health insurance companies. Life should be lived to the fullest and one should finding happiness in it. If a perceived improvement in appearance will give one joy, one should look for the best financial support and get it done rather than let the wish fade away.

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