Frequently Asked Questions

What kinds of surgery or medical procedures are not covered by insurance?

Although policies can vary greatly on what is considered a covered procedure, there are some guidelines that the majority of insurance companies follow when it comes to definitions of what they will cover, especially in the reconstructive or cosmetic arenas. For those of you who are considering these types of surgeries, the term reconstructive surgery refers to a procedure performed on abnormal structures caused by congenital defects, developmental abnormalities, trauma, infection, tumors, or disease. This can include surgery to improve function or to help provide what is considered a more normal appearance. Cosmetic surgery is defined as the reshaping of normal structures on the body to improve the self-esteem or appearance of a patient. An example would be breast augmentation. Insurance companies are the sole interpreters of these definitions. The best way to find out what is covered and what is not is to first peruse your policy or check your insurance company's Web site. If you can't find what you're looking for in either of those places, call the company directly and explain your situation clearly. Make sure to write down details and the name of the person you spoke with.

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