Once available almost exclusively to the rich and famous, plastic surgery is now everywhere. That doesn’t mean, however, that it is cheap. Although many reconstructive procedures are covered or partially covered by insurance, there are still many that are not. Furthermore, if your procedure is strictly cosmetic in nature, your health plan is not likely to offer any help at all to defray the cost.
With a starting price in the thousands for virtually every available procedure, many prospective patients just don’t have that kind of cash lying around. In such cases, prettier faces and shapelier figures have traditionally been financed via personal loans (including loans from friends and family), credit cards, and even home equity loans. Today, however, there are more options than ever before. Finance companies that specialize specifically in medical procedures (some specifically in plastic surgery) are cropping up all over the place, and people are practically lining up to take advantage of this option.
Financing Reconstructive Surgery
Many people want to know exactly what constitutes reconstructive surgery. Unfortunately, there is no one clear answer when it comes to which reconstructive procedures may or may not be covered under your insurance plan.
The term “reconstructive surgery” can refer to a procedure that restores the patient to a state that existed before suffering the effects of some trauma or disease. It can refer to the correction of a birth defect. It can even refer to surgery that offers some cosmetic benefit while at the same time improving function (such as an eye lift on a hooded eyelid, which improves the patient’s eyesight by lessening the obstruction of the hanging skin) or lessening pain or other physiological stresses (such as in breast reduction).
The only way to know for certain if a procedure is covered is to speak to the member services department at your insurance company. You will almost certainly be required to get the procedure approved before scheduling it, which will mean a visit to your primary care physician and possibly a specialist in addition to your plastic surgeon. Your medical team will need to examine you and provide documentation clearly defining why your procedure is medically necessary (or why it otherwise qualifies for coverage under your insurance plan).
There are exceptions to the above, the most notable being post-mastectomy breast reconstruction, which thanks to a U.S. federal law enacted in 1998, must be covered by your insurance plan. The law even requires that in the case of a uni-lateral mastectomy, procedures on both breasts are to be covered if needed to restore symmetry.
If your procedure doesn’t fall under any of these coverage categories, you will have to consider your other financing options just like those who are seeking surgery for purely cosmetic purposes. Enter the world of specialty financing.
Financing Cosmetic Surgery
Except where some function is improved or restored in conjunction with the cosmetic benefit, or in the very rare case where your health plan includes coverage for cosmetic surgery, you will be on your own in paying for that new nose (or new breasts, tighter jawline, slimmer thighs, etc.). You may consider putting it all on that new credit card with the low introductory rate, or even tapping into your home’s equity to finance your new look.
The good news is that your surgeon wants to make it as easy as possible for you to pay for your procedure. He or she probably even offers a convenient financing plan with forms you can fill out right in the office during your consultation. There are often plans available for people with all kinds of credit ratings, and the monthly payments can seem very reasonable.
The bad news is that dealing with these specialty finance companies can be a little tricky. Many of them like to use the time-tested used-car-salesman tactic of focusing solely on the “low monthly payment” while glossing over pesky little details like the actual interest rate or the length of the loan. Still others lure you in with the terms reserved for people with the highest credit ratings, then stick you with a much less favorable deal that is offered to those with less-than-perfect credit.
Some of these companies may offer truly good rates and terms, but make sure you read the fine print. If the numbers don’t add up in your favor, don’t let the convenience of “in-house” financing trip you up. Consider applying for a lower-rate personal loan or home equity line of credit, or even using a credit card if you have one with a really low rate (one that won’t go way up in a few months!).Keep in mind also that these finance companies often work only with specific doctors, so it is a good idea to choose your surgeon first and see which programs he or she works with, rather than the other way around. Choosing a surgeon is the most important decision you will make in this process, and you don’t want your financing options to dictate who performs your surgery.
The Old-Fashioned Way
There is one other option: You could do things the old-fashioned way and wait to schedule your surgery. Take the money that you would be sending in every month for your “low monthly payment” and put it into a special account that is earmarked for your surgery. Save until you have enough for your surgery, and then enjoy the new you, interest-free!
There May Be Help Available
To cover the cost of some reconstructive procedures, there may be help available through organizations like Operation Smile. They offer free or very low cost surgery to children with congenital birth defects such a cleft lip or palate. In addition, there are other charitable foundations which offer free or low cost surgery to victims of war or domestic violence.
Insurance Coverage: A Patient's Guide. Consumer Information Sheet. American Society of Plastic Surgeons http://www.plasticsurgery.org/patients_consumers/planning_surgery/insurance_coverage.cfm