Free Plastic Surgery: Getting Health Insurance to Cover

The words you use and the questions you ask determine whether you can get free plastic surgery.

Your health insurance and IRS tax savings can cover most expenses when the procedure step is medically necessary: addresses a disease or health condition.

Plastic surgery meets the criteria because it reconstructs facial and body defects caused by congenital deformities, accidents, or illnesses.

Cosmetic surgery fails the criteria because it reshapes healthy tissue to improve appearance or symmetry.

Learning the distinction between the two is the key that unlocks the door to an almost free (after deductible, copayments, etc.) operation.  

Getting Free Plastic Surgery

This section discusses alternative ways to get free plastic surgery when your health insurance company refuses to cover the procedure because the goal is cosmetic rather than medically necessary.

Free Money

It may be possible to get interest-free money to pay for plastic surgery deemed cosmetic by your insurance company. An IRS-sanctioned Flexible Spending Account (FSA) could make it happen while over-delivering benefits.

Interest-free medical loans with no credit check are viable using your FSA. Choose to contribute during open enrollment and schedule your procedure early in the plan year. Your employer must reimburse qualifying expenses immediately, giving you up to fifty-two weeks to repay the money using pre-tax payroll contributions.

  • Your employer cannot pull a copy of your credit report or charge interest
  • Pre-tax payroll deductions reduce your income subject to three taxes
    • Federal income
    • State income
    • FICA payroll

Your cosmetic surgery meets the qualifying medical expense definition if it “is necessary to improve a deformity arising from, or directly related to, a congenital abnormality, a personal injury resulting from an accident or trauma, or a disfiguring disease.”

FSA administrators follow IRS rules when making claims decisions, while insurance companies follow slightly different standards. Your case might fit one but not the other.

Financial Assistance

If you cannot get free plastic surgery through insurance, financial assistance in the form of a loan might raise the cash needed to pay for the procedure. Of course, you must be able to repay the money in installments over time.

Plastic surgery financing with bad credit requires a strategy and proactive steps. You cannot wait until you are in the doctor’s office and expect to qualify for their payment plan.

You want to secure your financial assistance before choosing a surgeon by applying to many sub-prime lenders simultaneously. Lender volume is the best antidote for bad credit and low approval odds.

Free Grants

For recipients, cosmetic surgery grants represent free money you do not have to repay, making it much easier to afford any procedure that insurance will not cover. However, demand often outstrips supply, so set realistic expectations.

Federal Grants

Federal grants are unlikely to lead directly to free cosmetic surgery. No government agency sends funds directly to individuals. Instead, the money flows to non-profits, universities, and state departments.

Free government money for bills and personal use is available through grant recipients, typically state agencies administering benefits programs. You might indirectly afford to pay for plastic surgery by reducing other household expenses.

  • Home repair
  • Utility bills
  • Child care
  • Rental housing
  • Medical care
  • Groceries

Charitable Grants

Free cosmetic surgery grants are sometimes available through charitable organizations and foundations. However, many entities covered in other online publications provide funding to doctors or patients in foreign countries.

Be careful not to waste your time chasing after foundations that award grants to physicians performing research activities to advance learning goals.

Other charitable organizations award grants to support doctors offering pro bono care to patients in foreign countries needing medically necessary procedures. US-based patients typically can get insurance to cover these operations (see below).

  • The Smile Train helps children born with cleft lips and palettes.
  • My Face helps children with craniofacial abnormalities.

Local Students

Free plastic surgery by local students is an unrealistic expectation when insurance will not pay claims for cosmetic procedures. Students graduate from medical school as doctors and then work in a four-year residency program, which may provide discounted services to low-income patients.

Begin with a national listing of residency programs to find a center near your home. Ask about fees and discounts connected with their educational training to get a complete estimate of the total charges. Trained faculty will supervise the work of resident plastic surgeons as they learn their craft.

Pro Bono

Pro bono plastic surgery after weight loss will prove challenging to find. Pro bono means for the public good and involves providing free services to people in need – typically low-income families and children.

Medicaid might cover plastic surgery after weight loss when medically necessary, making this a better avenue for low-income patients (see next section on getting health insurance to cover). Pro bono services are scarce for a simple reason: the provider must cover the cost of anesthesia, nurses, operating room fees, etc.

Insurance Covering Plastic Surgery

Plastic surgery is almost free when a specific third party foots the bill. Therefore, you should learn how to get health insurance to pay for the procedure: prove that it meets at least one critical underwriting standard.

  • Medically necessary: prevent, diagnose, or treat an injury or illness
  • Reconstructive: improvement or restoration of physiologic function

Necessary Procedures

Below are several popular procedures that are sometimes mostly free when proven medically necessary or reconstructive. Follow these examples to learn how to get insurance to pay for plastic surgery.

Skin Removal

You could get mostly free excess skin removal surgery if you prove that a Panniculectomy is medically necessary. You might get your health insurance to cover most skin removal costs after weight loss in at least two scenarios.

Excess skin removal surgery might be medically necessary when meeting at least two objective criteria, which you must document with pictures when pre-certifying coverage.

  • The Panniculus (an apron of excess skin and fat hanging from the abdomen) drops below the pubic bone, limiting your ability to urinate.
  • Excess skin causes chronic intertrigo (dermatitis occurring on opposed surfaces of the skin, skin irritation, infection, or chafing)


You might get liposuction free when proven to be medically necessary or reconstructive. You might get your insurance to pay most costs for liposuction in at least two situations.

Liposuction to treat lipedema could be medically necessary. Lipedema is an abnormal build-up of fat in your legs and arms, causing pain or limiting movement. Your insurance might cover this procedure if you establish the following.

  • A documented diagnosis of lipedema by a licensed physician
  • Failure to respond to 6 months of conservative treatment
  • Detailed treatment plan

Liposuction might be medically necessary to support breast reconstruction after mastectomy or lumpectomy to treat cancer. The harvesting and grafting of autologous fat might be preferred over implants.  

Nose Job

What qualifies you for a free nose job? You might get health insurance to cover a nose job if you prove the procedure is medically necessary.  

A rhinoplasty or septoplasty might be medically necessary when you can document any specific conditions or symptoms.

  • Rhinoplasty
    • Deformities of the bony nasal pyramid that cause symptomatic airway compromise
    • Reconstruction following treatments or illnesses
    • Deformity of the bony nasal pyramid caused by documented trauma
    • Trauma-related nasal airway obstruction leading to chronic rhinosinusitis
  • Septoplasty
    • Trauma to the septum leads to deformity
    • Reconstruction after surgical nasal excisions
    • Deviated septum that leads to medical disabilities

Letter of Necessity

Composing a well-supported letter of medical necessity with your doctor is the critical step toward getting your health insurance to cover any plastic surgery. The document should address the qualifying criteria established by the issuing company.

The requesting physicians should submit documentation to the insurance company for pre-certification, including photographs, measurements, chart records, and any other evidence supporting the specific diagnosis.

  • Address how it treats a disease or illness and why it is consistent with the applicable standard of care.
  • Include the appropriate ICD-10 and CPT codes and the prognosis or expected outcome.