Cosmetic
surgery is performed to reshape normal structures of the
body in order to improve the patient's appearance and self-esteem.
Cosmetic surgery is usually not covered by health insurance because it
is elective.
Reconstructive surgery is performed on
abnormal structures of the body, caused by congenital defects,
developmental abnormalities, trauma, infection, tumors or disease. It
is generally performed to improve function but may also be done to
approximate a normal appearance. Reconstructive surgery is generally
covered by most health insurance policies although coverage for
specific procedures and levels of coverage may vary greatly.
There are a number of "gray areas"
in coverage for plastic surgery that sometimes require special
consideration by an insurance carrier. These areas usually involve
surgical operations that may be reconstructive or cosmetic, depending
on each patient's situation. For example, eyelid surgery (blepharoplasty)
— a procedure normally performed to achieve cosmetic improvement —
may be covered if the eyelids are drooping severely and obscuring a
patient's vision.
