Body Procedures Covered by Insurance

Insight from a Top Beverly Hills Plastic Surgeon

Any area of the body may require reconstructive surgery as part of medical treatment, particularly after acute trauma or injury. When the normal treatment protocol includes reconstructive or plastic surgery, insurance companies typically pay for all or most of the costs related to your procedure. Beverly Hills plastic surgeon, Dr. David N. Sayah offers a number of surgical procedures for the body that are often covered by health insurance.

For guidance in working with your insurance company to determine if you are eligible, or for more information about which procedures may be covered by plastic surgery insurance, please contact The Sayah Institute at (310) 385-0000.

Hands & Fingers

• Carpal Tunnel: The painful symptoms of carpal tunnel syndrome afflict millions of Americans every year. Hand surgery to correct the nerve compression responsible is typically covered by insurance.
• Infections: Certain infections of the hand or fingers may require surgery for effective care. Depending on the level of correction needed, reconstructive surgery may be recommended after the primary treatment to restore form or function.
• Fractures: Although simple fractures rarely require surgery, compound fractures that pierce the skin often need a more involved approach to facilitate proper healing. Surgery and other procedures to treat fractures are typically covered by insurance.
• Lacerations: Severe lacerations on the hand or fingers after an acute trauma or accident could need surgery ranging from simple sutures to more complex reconstruction of the skin and soft tissues.
• Trigger Finger: This painful condition causes permanent contraction of the fingers, and can require surgical release of the affected tendon in order to restore full joint movement to the hand as well as alleviate discomfort.
• Ganglion Cysts: Though normally painless, some ganglion cysts may grow in such a way that a nearby nerve is compressed, causing painful sensations or numbness and tingling. Needle aspiration may be sufficient treatment, although surgical excision could be required.
• Dupuytren’s Contracture: This disease affects the fascia in the hand, eventually causing a thickening and contraction that may require surgery to resolve. Hand surgery removes the affected tissue, restoring full range of motion through the hand and fingers.

Legs & Body

• Excess Loose Skin/Pannus: Excessive loose skin throughout the thighs, arm and trunk, as well as the pannus (the lower abdomen) can only be removed surgically. Left untreated, patients may experience recurrent skin irritation, infections and other health concerns.
• Post-Gastric Bypass: Following weight loss surgery, body contouring procedures are often regarded as medically necessary in order to address any excess skin or tissue that are the common byproducts of such rapid weight loss.
• Umbilical Hernia: Weak spots in the abdominal wall may be susceptible to the development of an umbilical hernia. During surgery, any protruding bowel or tissue is restored to its proper placement, and the abdominal wall is repaired.
• Varicose Veins: Varicose veins may cause aching pain that worsens after sitting or standing for long periods, sometimes to the point of interfering with normal daily activities. Varicose vein treatment can collapse the vein to resolve the problem at the source.
• Ventral Hernia: A ventral hernia may develop as the result of a surgical wound that hasn’t completely healed, allowing soft tissue or a section of bowel to protrude through the abdominal wall. A skilled surgeon can help to correct and repair these abnormalities.

Skin

• Acne: Although the specifics will vary for different health insurance providers, several acne treatments may be covered by your policy. These could include skin rejuvenation treatments, chemical peels or acne surgery.
• Actinic keratosis: These raised, rough patches of skin may result after long-term sun exposure, and have the potential to develop into skin cancer. Topical treatments, cryosurgery and chemical peels are among the most common treatments for actinic keratosis.
• Burns: Severe burns may require multiple procedures and skin grafts to improve cosmetic appearance, as well as to restore function of the affected area if mobility is limited. Surgical skin treatments are medically necessary for burn victims.
• Hair Removal: Laser hair removal may be covered by insurance if related to a medical condition. For example, gender reassignment surgery may include hair removal, as can treatment for polycystic ovarian syndrome or chronic folliculitis.
• Hemangioma: This strawberry-colored birthmark is actually the result of blood vessels that develop abnormally under the skin. In most cases harmless, some instances can interfere with breathing or vision. These can be removed through laser surgery.
• Keloid/Hypertrophic Scars: While scar tissue growth is a normal part of the body’s healing process, keloid or hypertrophic scars are examples of abnormal scar growth. If they become painful or limit normal movement, they can be removed through surgical excision, sometimes followed by radiation treatment.
• Mole Check: Sudden changes in mole size, color or shape can be a precursor to a more serious health concern such as skin cancer or precancerous lesions. For this reason, mole checks performed by a doctor are an important part of preventative care.
• Scar revision: Most scars heal to nearly invisible, although sometimes the normal healing process doesn’t go quite as predicted. Scars that are painful or interfere with normal motions may require scar revision surgery to correct.
• Skin Grafts: In essence, skin grafts are like a transplant of skin from one area of the body to another. This is usually performed due to a serious injury that caused major skin loss, severe burns, ulcerous lesions or certain skin infections.
• Spider Veins: Spider veins can be caused by several different health conditions, including the backup of blood, an injury or hormone fluctuations. When associated with a more primary health concern, spider vein treatment may be eligible for insurance coverage.
• Sun Spots/Damage: Exposure to the sun can result in small brown spots (freckles) or larger dark spots (age spots or sun spots). In some cases, larger areas of more diffuse hyperpigmentation can also indicate sun-damaged skin. Resurfacing treatments serve as a preventative treatment to remove sun-damaged skin cells and reduce skin cancer risks.