Health Insurance Coverages

If you are planning to undergo plastic surgery, learning the basic background information like what are the preparations before the operation, the medical approach to be done inside the operating room and how you will be look like after the surgery has been completed. On the other hand, it is also important to know the financial matter and how all the costs will be paid. To understand the coverage of your health insurance benefits, some organization such as The American Society of Plastic Surgeons (ASPS) provided some helpful information in better understanding about this matter.
Remember, the insurance policy will depend based on the agreement between the policy holder and the insurance company. He or she who will undergo such surgery will be responsible for the succeeding amounts not covered by their plan. Only the reconstructive surgery, an operation performed to improve abnormal structure of the body due to congenital effects, infection, tumors, etc., is generally covered and not an elective cosmetic surgery which is not considered as medical necessity.
Please take note that there are also exceptions in a case to case basis. An example given is the eyelid surgery for cosmetic improvement. This can be considered if the eyelids are already obscuring and affecting the patient’s vision. The situation is called “gray areas” wherein the policy carrier will make necessary judgment as to whether the plastic surgery is needed or not. Authorization and approval is mandatory before the operation and some additional documentation afterwards to determine the total amount of bills the insurance company will cover.
The policy holders will be given a prerogative on how they would like to pay the insurance. It can be deductible wherein the patient will shoulder the total medical expenses then after the requirement is reached, that is the time the insurer will begin to pay the covered medical costs.  Another option is a flat-rate copayment, a defined sharing in medical billing which the patient initially pays. The company now here is responsible for the remaining balance that is covered by the insurance. Lastly, a percentage=based copayment which have other variations. Only percentage share of the total medical expenses that the patients pay will be covered.
There is also a dual coverage wherein the patient is under her spouse’s health insurance. It is more beneficial because both plans can cover most of the surgery charges. The co-payment will be 80% of coverage on the primary carrier, the patient, and the remaining 20% based on the spouse’s insurance terms and policy.
An important reminder, make sure that you have a clear view of the charges and determine the remaining balance you are expected to pay. Present your insurance card, and if applicable, your spouse’s card as well, on the first visit to your plastic surgeon. Keep all the documents, files, and receipts organized every now and then for future reference.