If you’re interested in cosmetic surgery in Oxnard but want to know if your health insurer will cover it, call your health plan and find out. Health insurance companies require the procedure to be “medically necessary” in order to be covered. Some cosmetic procedures are paid for by health insurance companies while others are not.
For example, breast reduction due to back pain or breast reconstruction needed because of breast cancer are two surgeries that are usually covered by health insurance. With back pain caused by large breasts, some health insurers require a years worth of documentation, physician visits, etc. that back up the ongoing condition. Some require trips to a chiropractor before the augmentation will be covered. Each carrier sets their own rules.
Your physician, working in collaboration with your cosmetic surgeon, can write letters to your health insurer requesting coverage or appealing a denial. As a last resort, get your case in front of the insurer’s medical director, who is a physician. A fellow doctor is more likely to be motivated to ensure good medical care of the insurer’s clients and more likely to approve the coverage. Please contact the staff at Pacifica Center for Plastic Surgery at 805-484-2855 or pacificaplasticsurgery.com for more information.