Do you have health insurance and are you considering cosmetic surgery? Here we will clarify this recurring doubt about whether medical expense insurance covers aesthetic procedures such as plastic surgery.
Despite the fact that most insurers that offer insurance for major medical expenses stipulate within their general conditions that cosmetic surgeries or cosmetic procedures are not covered, there are exceptions that are covered by your insurance for major medical expenses.
Below we will show you which cosmetic surgeries your major medical expenses insurance covers. It is important that you consult the general conditions of your insurance, as well as the title page of the policy, since there you will be able to see the last word on which conditions are covered and which are not.
Nose job or Rhinoplasty
Rhinoplasty is a surgery use to change the shape of the nose; see the Mayo Clinic definition here. Your major medical insurance could cover a large part of the costs of a rhinoplasty as long as the following conditions are meet:
- Have a minimum of 2 years of seniority with your major medical expenses insurance.
- Demonstrate through x-rays and clinical studies why you need this intervention, for example, it may be necessary because you have a deviated septum and this affects your breathing considerably.
- Depending on the insurer, you will have to pay your deductible plus a 30% coinsurance.
Generally, a rhinoplasty in Mexico costs $30,000, so if we subtract the 10% deductible that you will have to pay plus the 10% coinsurance, you will end up paying approximately $24,000, which translates into significant savings in this surgery.
Ophthalmic corrective surgery
If you are tire of using annoying contact lenses or prescription lenses and you are thinking of having laser surgery so you don’t have to use them again, we have good news since your major medical insurance will most likely cover a part of said procedure. To access this surgery you must meet the following two conditions:
- Comply with the waiting period of 2 years.
- Have more than 5 diopters in both eyes.
In case you do not have more than 5 diopters in both eyes, the waiting time will change from 2 to 4 years and this will depend exclusively on the insurer you are with.
Bariatric surgery
Although this surgical procedure is mainly design for the health of patients who request it, it is also well known that people use it as a definitive method to lose weight in a much healthier and more permanent way.
As with the previous procedures, you must meet certain conditions, such as:
- Have a minimum seniority of 4 years with your insurance for major medical expenses.
- That this procedure is the first bariatric surgery that you perform.
- Your body mass index must be greater than 40.
- Being diagnose with a disease that is directly relate to obesity such as cardiovascular problems and type 2 diabetes.
What other cosmetic surgeries does my major medical expenses insurance cover?
The major medical expenses insurance will cover those surgeries that are reconstructive and that are need as a result of accidents or congenital illnesses that are duly stipulate within the policy. It will also cover those surgeries that are reconstructive and that are need as a result of accidents or congenital illnesses that are duly stipulate within the policy.
Here are some examples of cosmetic procedures that your major medical insurance might cover:
- Correction of scars.
- Breast reduction in case, due to the size of your breasts. You suffer too much physical pain and you cannot lead an optimal life or cannot perform activities.
- Breast reconstruction after removal of cancerous tissue, or reconstruction in case of serious disfigurement.
What options does the market offer me?
The major medical insurance market in Mexico has evolved to adapt to the needs of patients. For this reason, some insurers have included cosmetic surgical procedures within their additional coverage.
You can also find the following services within the additional coverage for cosmetic surgeries:
- Ophthalmology
- Dermatology
- Dental procedures
On other occasions, this type of additional coverage is use to pay for possible surgical complications. That arise from an aesthetic intervention. Generally, its validity does not exceed 30 days after the surgical procedure is perform. Nor will it apply if you have exhausted the insured sum of your major medical expenses insurance.
In any case that you decide to carry out a major cosmetic surgery. We recommend you take out your major medical expenses insurance with assistance or additional coverage that protects you in the event .That you suffer complications derived from the procedure that you wish to undergo.
Consult with your treating doctor the possible consequences of undergoing the type of surgical procedure you have in mind and evaluate the expenses. That these would generate in your insurance.
