Health insurance covers a part of the plastic/cosmetic surgery's payment, con or pro?

Unless it is restorative surgery or to remedy a deformation, tumor, etc. then I do not see a reason for covering it.

I believe this is actually the case for people in the military and their immediate family. At least that’s what I’ve heard.

And who are you to judge what a “good” reason for doing something like this is?

I think insurance already does cover for deformities and reconstruction as @ragingloli pointed out.

Although I remember a fluther question about reconstruction for mutilation of the female genetalia, that it was not being covered.

Most of the time this is simple elective surgery and should not be covered in most cases.

This stuff is expensive and every “new benefit” that is added to a policy raises the cost of everyone’s premium.

@lilikoi – There’s the rub. How do you define what is elective and what is medically necessary. Restorative surgery is clearly needed. Breast augmentation,unless subsequent to a mastectomy or lumpectomy clearly is not covered. The insurance policy defines what will or will not be covered.

Whose decision is it? The insurance contract is negotiated by the carrier and the contract holder. If the carrier chooses not to cover something then they will not cover it. Same for the employer, except when State insurance regulations require coverage of a particular procedure.

It is not the decision of some third-party like the ‘Death panels”: that Ms. Palin saw lurking under every hospital bed.

It is insurance coverage, a contract entered into by two parties and they can decide what goes into it and what is excluded.

SRM

Multiple people have told me that military and their immediate family get insurance policies that cover breast augmentation regardless of whether or not they’ve had a mastectomy or lumpectomy. I wonder if anyone can confirm this?

Yes I understand how insurance policies and companies work. I was just commenting that “good” is subjective. I could argue, for example, that some people get implants in the pursuit of happiness, and that happiness translates to healthfulness which in turn translates to fewer medical expenses in the long run.

Ask me about the health insurance system itself; that’s a much more important problem that, if solved (not holding my breath), would render this thread moot.

Insurance covering elective cosmetic surgery would be like using car insurance to get a new paint job.

@beancrisp
I think that is a brilliant analogy.

When a women needs to have her breast(s) removed due to cancer, the insurance should also cover the cost of reconstructive surgery.

A medical insurance company is only as good as it’s capital adequacy ratio. Meaning, that the amount of females that would like to reconstruct themselves in various ways would deplete the funds faster than a tap left running. The result would be a realignment of funds and important high costing procedures like MRI’s being offered only with a sub payment then being taken away all together.

Medical insurance should keep it’s primary focus which is health care.There is also cross subsidization occurring within a fund meaning healthier body’s subsidizing the more sickly. So a large portion of fund recoup would be lost.

fair enough if it is private (e.g. USA) and within the contract.

@lilikoi I do have a friend who wanted her breasts a little rounder while she was in the army. This is about 2 years ago. Anyway, the injected silicone directly into her breasts—of course that would probably be considered criminal in the private sector, although maybe no back then. I have never heard of that being done to anyone else though. It was free, just like all medical care on base is free.

There is a possibility that augmentation is “covered” in the military or gets done so doctors can practice. Teaching hospitals like to do surgery. That would be slightly different than “insurance covering it.” Remember military doctors are salaried, that includes the anesthesiologist, nurses; the operating room is already there, the only real cost is electricity, the breasts inserts, and whatever supplies are used during surgery and for recovery like medications, gauze, bandages, etc. It would not come close to the $10K that might be charged on the outside, I’d be surprised if it was $1k.

That should be 25 years ago, sorry for the typo.

@davidbetterman Most insurance companies indeed cover reconstructive breast surgery following cancer surgery.

Most say they do, but some refuse to do so when the time comes.

I think insurance should cover restorative only – unless there’s a surgical complication that requires additional hospitalization or treatment like infection or cardiac arrest. At that point, I think the insurance should kick in.

No unless there is a medical reason for having the surgery.

Well when it comes to this, then composite fillings shouldn’t be covered at all (and some Medicaid does not cover it) because usually you get it because it matches the other teeth and isn’t silver. Cosmetic, right? But silly to deny.
Not all cosmetic involves fake boobs. I think that’s most peoples first thought.

@davidbetterman My mom’s covered it, thank goodness.

Restorative or reconstructive surgery, yes. Purely cosmetic surgery shouldn’t be covered as it will raise everyones premiums. I know that there are many “gray areas” in this. The orthopedic and reconstructive surgery my wife needed wasn’t covered by anything (we weren’t married at the time), none of this was purely “cosmetic”. Over $200k out of pocket, but love doesn’t count costs.