While many people avoid discussing cosmetic surgery or procedures publicly, they’re more commonly done than you might initially think. According to the American Society of Plastic Surgeons, more than 1.8 million cosmetic surgeries were performed in the United States in 2018. This, of course, doesn’t count non-surgical procedures that patients seek out to improve their image, such as dental corrections, non-surgical fat reduction, or vitiligo treatments. In an age where cosmetic procedures are on the rise, why doesn’t insurance cover cosmetic medical treatments? Should insurance be changing to accommodate these procedures?

The Cost Of Insurance

Many patients dread having to go through their insurance for any medical procedure, but it’s not just a nightmare for the patient. It costs nearly $250 billion for insurance providers to process 30 billion healthcare transactions each year. Currently, a majority of health insurance options available to the general public do not cover cosmetic procedures – however, some procedures will be covered if the insurance company determines that they’re “medically necessary.” This usually involves some degree of documentation from a healthcare provider, and not all patients are able to access this. Therefore, some procedures often considered “cosmetic” may actually be necessary for day-to-day comfort and well-being, but won’t be covered by most insurances.

Common Procedures

While cosmetic surgeries cover a wide variety of procedures, there are a few that are more commonly seen than others. Weight loss and breast augmentation, for example, are two of the most common cosmetic procedures today. However, while usually used for cosmetic reasons, there are a few occasions when these procedures are without question medically necessary, such as in the case of extreme weight complications or rehabilitation after breast cancer. Because even the most common procedures can sometimes lie in a grey area, it can be difficult to determine exactly what insurance should cover and when.

Cosmetic Improvements Without Surgery

Likewise, not all cosmetic procedures require surgery, and this further complicates when insurance should cover procedures. For example, some four million Americans are wearing braces, according to the American Association of Orthodontists. Often, braces are used to treat cosmetic imperfections in tooth and jaw alignment. With four million patients using braces at any given time, it’s unlikely that all of them are being worn to fix medically necessary issues. However, braces are often covered under a patient’s dental insurance.

In addition to the growing use of existing treatments for cosmetic purposes, other treatments are quickly evolving to be performed as quick outpatient procedures. One example of this can be found in ways that hair loss is being treated today. Follicular unit extraction, also known as follicular transfer, is one of the primary methods of obtaining follicular units, naturally occurring groups of one to four hairs, for hair transplantation. While hair transplants were previously invasive, this method is often performed quickly with little downtime. With treatments changing rapidly, insurance is often left playing catch-up in how it classifies certain procedures.

Should Insurance Be Shifting?

While most insurance plans don’t cover cosmetic medical procedures, perhaps we are reaching a point in medical development where they should be. Even the average visit to the ER, which comes in at around $1,233, is typically covered by insurance. With so much of a grey area surrounding cosmetic surgery and other medical procedures, health insurance will need to shift in order to address the growing number of cosmetic procedures available to patients today. Otherwise, patients will be forced to pay for these out of pocket, even if in some cases they could mean dramatic quality of life improvements for patients.