American Society of Plastic Surgeons
For Medical Professionals
5 years ago

Inf request

Which cosmetics surgeries are cover by insurance?

Procedure: Eyelid Surgery

Replies 6

Steven Wallach
ASPS Surgeon
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No cosmetic surgery is covered by insurance.

Debra Johnson
ASPS Surgeon

The plastic surgeries that are covered by health insurance all have to have some functional impairment involved. Breast reduction is covered since patients have significant back, neck and shoulder pain.

You tagged eyelid surgery, so sometimes upper eyelid surgery can be covered if the eyelid skin is so heavy and excessive that it hangs down over the lashes and obstructs vision.

Panniculectomy, the removal of excessive skin and fat from the abdomen, is sometimes covered in massive weight loss patients since they tend to have trouble with rashes and odor in the skin folds.

Cosmetic surgery, where you are improving on a normal appearance and not correcting any medical problem, is not covered by insurance.

Peter Aldea
ASPS Surgeon

Cosmetic Surgery = Surgery intended to improve on normal.

Reconstructive Surgery = Surgery intended to improve on ABnormal (Due to birth defects, injuries or disease).

In general, Medical Insurance companies will NOT pay for Cosmetic Surgery. The sole exception MAY BE (depending on the terms of your individual policy) the removal of excessive upper lid skin which is proved to cause obstruction of the visual fields. Because this area is so rife with fraud, insurance companies are very hard to convince in this regard.

Nelson Castillo

Thank you for your question. No cosmetic procedure is covered by insurance.

Jon Ver Halen

Dear Regina,

Hello and thank you for your excellent question. In general, cosmetic procedures are not covered by insurance. However, reconstructive surgeries may be covered by your insurance. It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!

Daniel Allan



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