Liposuction, in most cases, is considered by insurance companies to be elective cosmetic surgery. Therefore, it typically will not be covered under your healthcare policy. That said, as with many other forms of plastic surgery, there are exceptions to this rule.
If you need liposuction for therapeutic/medical reasons, then there is a chance that insurance could pay for it. There are two big factors to keep in mind when determining whether your surgery is medically necessary or purely cosmetic.
Those two decisive factors are:
Let’s break those down in deeper detail.
Reconstructive vs. Cosmetic Surgery
Most liposuction patients will say that their surgery was done to improve their physical and mental wellbeing. The removal of stubborn fat and the smoothing out of loose skin can enhance a person’s quality of life. However, determining whether those benefits are truly essential to that person’s body function is tricky. The underlying reason for the procedure is what matters when dealing with insurance companies.
The big question to ask yourself is, “Is this surgery medically necessary?” If the answer is yes, then it should be covered.
It’s similar to how breast reduction surgery is covered when it’s done to reduce back pain or when a nose job is done to fix a broken nose, insurance will pay for it. By the same reasoning, liposuction that is performed to remedy a specific health issue is a medical necessity.
The important definitions to keep in mind here are reconstructive and cosmetic.
Reconstructive surgery is generally defined as an operation aimed at fixing “abnormalities” caused by disabilities, developmental issues, trauma, infections, tumors, or diseases. This classification of surgery improves a person’s body function or to gives them a “normal” appearance, thereby improving their quality of life.
Excess fat deposits and sagging skin are generally not considered “abnormalities.” However, if an abnormal number of fat cells have accumulated in your abdomen due to an underlying condition or a traumatic event, then liposuction surgery on that area could be deemed reconstructive.
Cosmetic surgery is defined as any procedure that enhances or reshapes the structures of a person’s body to improve their appearance and boost their confidence. While a cosmetic procedure does, in many cases, improve a person’s quality of life, it is usually not a medical necessity and therefore not covered by insurance.
The ultimate ruling on whether your surgery is cosmetic or reconstructive will come from the insurance company, which brings us to our second biggest factor.
Types of Insurance
Not all health coverage is created equal. Liposuction patients have all different types of insurance policies depending on factors such as their career, income, age, location, family, military status, etc. So, saying that their fat removal or body contouring procedure isn’t “covered by insurance” is a bit of an over-generalization.
To get an idea of what your insurer offers, the first easy step would be to contact them. Either contact the company directly or ask your health insurance administrator what is covered under your current plan.
If a Mommy Makeover, for example, is not covered, don’t end the conversation there. They may still be convinced to pay for part of the surgery if it is half a health necessity and half a cosmetic concern. These things aren’t black and white. It’s worth exploring all possible options. Your doctor should be able to help you with this. There are also potential medical expenses outside of the surgery itself such as prescriptions that could be covered under your policy.
Among the different types of plastic surgery, liposuction is one of the least commonly covered by insurance. In terms of coverability, it is on par with eyelid and breast augmentation. However, as we mentioned, there are some exceptions to this rule. It’s worth exploring your options and seeing if there are ways that your insurer can help cover some if not all of the costs related to your operation. If you have questions about the affordability of Sono Bello liposuction, check out our article on the subject. Or schedule a free consultation today to speak with a team member about your options.
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