Plastic surgery

Plastic surgery is a surgical specialty that reconstructs, restores, or alters body parts for medical or cosmetic reasons. Insurance companies such as Aetna and UnitedHealthcare typically cover plastic surgery only when medically necessary, like breast reconstruction after mastectomy under the Women’s Health and Cancer Rights Act of 1998, as confirmed by Your Insurance Info.

Insurers exclude coverage for elective procedures including facelifts, rhinoplasty for appearance, or liposuction unless linked to documented health conditions. Policies require preauthorization and documentation from physicians proving necessity for covered surgeries such as cleft palate repair or burn treatment.

Out-of-pocket costs average $3,000–$15,000 per procedure without insurance according to the American Society of Plastic Surgeons (ASPS) 2022 report. Medicaid covers reconstructive plastic surgeries in cases like congenital defects but excludes purely aesthetic enhancements such as Botox injections or breast augmentation.

Deductibles and copays apply even for approved procedures; Blue Cross Blue Shield reports average deductibles of $1,500–$5,000 on individual plans in 2023. Appeals processes exist if insurers deny claims for medically indicated surgeries with supporting evidence from board-certified surgeons.