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.  

How to Get Plastic Surgery for Free

Establishing the medical necessity is how you can get plastic surgery almost for free. Then, your health insurance might cover most of your costs, and the IRS could reduce them further.

Free Plastic Surgery Procedures

You can score almost free plastic surgery by getting your insurance to cover the procedure (see below for more details). If successful, your plan would pay the majority of expenses, leaving you to fund only the deductible, coinsurance, and copayments – if applicable.

Consider these examples that illustrate the fine line between plastic (medically necessary) versus cosmetic (enhances appearance) designations.

Financial assistance for surgery without insurance is far more limited.

Excess Skin Removal

Patients might be able to score almost free excess skin removal surgery in 2021 after dramatic weight loss. Your insurance could pay most of your Panniculectomy expenses when you can show that the extra epidermis affects your health.

You do not need to find plastic surgeons who perform pro bono excess skin removal when a third party has a contractual obligation to cover the expense: when it is medically necessary.  

Nose Job

A similar strategy answers how patients can get a primarily free nose job. Your insurance could pay most of your expenses when you can show that a crooked proboscis affects your health.

You do not need to find pro bono plastic surgeons that perform nose jobs when a third party has a contractual obligation to honor claims: when it is medically necessary.

  • 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

Mommy Makeover

Likewise, a few lucky women could get their mommy makeover almost for free if their insurance pays for most of the expenses. Portions of this type of plastic surgery could be medically necessary.

A mommy makeover can consist of four separate procedures with a different rationale for why it might address an underlying health condition.

  1. Breast Reduction
    1. BMI under 35
    2. Postural backaches
    3. Skinfold irritation
    4. Ulnar nerve numbness
  2. Tummy Tuck
    1. Relieve back pain
    2. Performed with other covered procedures
      1. Panniculectomy
      2. Breast reduction
      3. Hernia repair
      4. C-section
  3. Liposuction & Body Lifts
    1. Cellulitis
    2. Skin ulcerations
    3. Persistent dermatitis

Free Money for Plastic Surgery

The federal government offers free money for plastic surgery under an alias: tax-deductible medical expenses. You have three IRS-approved methods to reduce the net cost of your operation.

  1. Itemized deductions
  2. Flexible Spending Accounts
  3. Health Savings Accounts

You can find this federal grant money buried in the fine print published by the IRS. “You can include in medical expenses the amount you pay for cosmetic surgery 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.”

As you can see, this phrasing is very similar to how insurance companies determine whether to honor claims for medically necessary procedures.  

How to Get Insurance to Pay for Plastic Surgery

The trick to getting health insurance to pay for plastic surgery is to ask the right questions. Unfortunately, many patients begin with misconceptions about how the process works.

  • The incorrect question is what insurance company covers plastic surgery
  • The correct problem is how do I demonstrate the medical necessity so that the underwriting department will preauthorize the procedure and honor the subsequent claim

Letter of Medical Necessity

Composing a letter of medical necessity is critical to getting your health insurance plan to cover any plastic surgery. Your physician composes and signs the letter of medical necessity demonstrating that the procedure treats a disease or medical condition.

The insurance company may require the letter before issuing a preauthorization and paying the claim submitted by your provider. Ensure that the document includes supporting (photos, diagnostic images, and prior paid claims).

  • Unnecessary: cosmetic surgery that reshapes healthy tissue to improve appearance or symmetry
  • Necessary: plastic surgery that reconstructs facial and body defects caused by congenital deformities, accidents, or illnesses

Which Insurance Company

Asking which health insurance company covers plastic surgery is a poorly phrased question and could lead you down the wrong path.  

All insurance companies and plans pay for some plastic surgeries when medically necessary and follow similar underwriting standards when preauthorizing operations and adjudicating claims.

In other words, your symptoms and underlying health condition are what matter. It is irrelevant if a friend or person in an online forum stated that one of these insurance companies or plans paid for their specific procedure.