Free Plastic Surgery: Getting Health Insurance to Cover

The words you use, the questions you ask, and the places you look often determine whether you can get free cosmetic or plastic surgery.

Instead of asking what health insurance covers cosmetic or plastic surgery, ask when the procedure is medically necessary.

Most carriers follow similar guidelines when determining whether a procedure is medically necessary, so switching plans is not the answer.

Medically necessary means the services diagnose or treat an illness or injury, condition, disease (or its symptoms), and meet accepted medical standards

Plastic surgery that satisfies this standard reconstructs facial and body defects caused by congenital deformities, accidents, or illnesses.

Free Plastic Surgery

Patients can often obtain free plastic surgery by getting their health insurance to cover the procedure. Therefore, collaborate with your surgical office to establish the medically necessary reason you need the operation.

Plus, you have no excuse for being uninsured because you schedule elective procedures at a convenient time.

Follow several examples for establishing a medically necessary reason, rather than asking what health insurance covers plastic surgery.

Table Of Contents

Gynecomastia

Free gynecomastia is possible when the procedure typically falls into the plastic surgery category. Again, asking what health insurance covers gynecomastia is unlikely to help because your focus should be establishing medical necessity.

While man boobs might be a source of embarrassment or shame, they generally do not jeopardize your health. However, your insurance might honor claims for mastectomy gynecomastia if you meet one or more of these criteria. [1]

  • Functional impairment (skin irritation or pain)
  • Tissue removed is glandular, not fatty
  • Grade II or larger breast enlargement
  • The condition persists after less invasive medical treatment

Skin Removal

Patients might be able to score free skin removal surgery after dramatic weight loss. Once again, asking which health insurance covers panniculectomy is the wrong approach.

A better strategy is to work with your provider to establish the medically necessary reason for the plastic surgeon to remove excess skin.  

Mommy Makeover

Health insurance might cover portions of a mommy makeover surgery, making some parts of the procedure free of charge. Again, the trick lies in establishing medically necessary reasons.

A mommy makeover can consist of four separate procedures with a different rationale for why it might fall into the plastic surgery category (medically necessary).

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

Pro Bono Cosmetic Surgery

Pro bono services for cosmetic surgery are the primary route because procedures that reshape healthy tissue to improve appearance are not medically necessary.

In this case, asking which health insurance covers cosmetic surgery does not bring you closer to an answer because the answer is none.

Cosmetic surgery financing is often the better alternative for patients who cannot afford to pay out-of-pocket today because grants, charities, and students rarely provide the answer.

Grants

Grants for cosmetic surgery are an unlikely source of free money to pay for your procedure. The federal government provides grants to universities, state agencies, and non-profit organizations to foster the public good or to bolster the economy – not individuals.

For instance, the Plastic Surgery Foundation runs a grant program designed to support industry research rather than helping low-income individuals who cannot afford the out-of-pocket costs.

Charities

Free cosmetic surgery offered through charitable organizations is possible for a small number of patients fitting into narrow categories. Keep in mind that charities often rely on the generosity of donors and the willingness of surgeons to perform pro bono services.

In other words, needs frequently outstrip resources.

Very Well Health maintains a listing of charities offering limited financial help for individuals wanting reconstructive surgeries. Notice that many are medically necessary, meaning insurance picks up most of the cost anyway.

  • Children born with cleft lip or palate
  • Disfigured domestic violence victims
  • Tattoo removal services
  • Survivors of accidents and diseases

Students

Free cosmetic surgery by students is another likely dead end. A more realistic expectation is reduced fees for procedures performed by residents while supervised by experienced faculty.

  • Third and fourth-year students in medical school cycle through six-week rotations of each specialty area and may assist with surgery but never operate themselves.
  • Surgical residents complete their training after graduating from medical school and enter a residency program affiliated with a university-based hospital system.

Begin with this list of plastic surgery residency programs, understanding that discounted care is viable – if you can identify a school near you with availability.


Article Citations

[1] BCBS of Tennessee Gynecomastia

[2] BCBS of NC Medical Policy