Cosmetic surgery performed by Dallas plastic surgeons is usually not covered by health insurance because
it is elective.
Reconstructive surgery is performed on abnormal structures of the body, caused by congenital defects,
developmental abnormalities, trauma, infection, tumors or disease. It is generally performed to improve
functions, but may also be done to approximate a normal appearance.
Reconstructive surgery is generally covered by most health insurance policies, although coverage for
specific procedures and levels of coverage may vary greatly.
There are a number of "gray areas" in coverage for plastic surgery that sometimes require special consideration
by an insurance carrier.
These areas usually involve surgical operations which may be reconstructive or
cosmetic, depending on each patient's situation. For example, eyelid surgery (blepharoplasty) - a procedure
normally performed to achieve cosmetic improvement - may be covered if the eyelids are drooping severely
and obscuring a patient's vision.
Below is a list of some cosmetic and reconstructive surgery procedures that your insuance may cover. This list
has been compiled with data from the American Society of Plastic Surgeons.
Once again, this is aggregate data and
you should check with your insurance company for specific coverage.
- Abdominal Surgery: If performed to improve or eliminate health
problems such as back pain, sores, hernia, rashes, or help improve the ability to walk normally.
.
- Breast Surgery: If performed to correct asymmetry, reduce large breasts causing health problems,
reconstruction due to loss, congenital absence (was born with only one breast), or reduce large male breasts
.
- Ear Surgery: If performed to correct deformed ears by birth, disease, or injury.
.
More examples of plastic surgery procedures that most insurance does cover.
- Eyelid Surgery: If performed to correct drooping eyelids that are causing vision problems or
correct eyelids that are turned in an abnormal way.
.
- Facial Surgery: If performed to balance the appearance if caused by paralysis, treat deformities
in the facial muscles, head, or neck.
.
- Hand Surgery: If performed to treat carpal tunnel syndrome, Dupuytren's contracture, nerve injuries,
tendon injuries, fused fingers, or other deformities.
.
- Nasal Surgery: If performed to correct deformities resulting from birth, disease, or
problems with breathing.
.
If you feel you may fall into any of these categories it is important to speak with your doctor.
Your doctor can confirm if your condition would be considered reconstructive and can
help you with contacting your insurance company.
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