Will insurance cover elective procedures?
It might seem odd to lump vasectomies and liposuction together with angioplasties and cataract removal. As long as the procedure is deemed immediately medically unnecessary, regardless of the benefit, it will be classified as elective, thus releasing your insurer from an obligation to offer coverage, or greatly reducing the amount of coverage. Generally, HMO plans don't cover elective procedures. PPO plans may cover certain elective procedures, such as an angioplasty, with you paying a percentage of the bill and the co-pay. These procedures vary from plan to plan, so be sure you are aware of what is covered in your plan before scheduling a procedure with your doctor. Finally, in a fee-for-service plan, your high premiums and up-front costs are rewarded with more coverage for elective procedures. However, you should still check to be sure your elective surgery is included.
There are a few key exceptions, including breast reconstruction following a mastectomy, rhinoplasty to correct severe breathing restrictions, reconstructive surgery after a severe accident and bariatric surgery if your weight is an immediate danger to your health.
For more information on elective procedures, health insurance and related topics, check out the links below.
Related How Stuff Works Articles
More Great Links
- Angioplasty.org: History Center http://www.ptca.org/nv/history.html
- Elective Procedures.Org http://www.electiveprocedures.org/seminar/default.aspx
- Find Articles: Liposuction Ranks as Top Cosmetic Procedure http://findarticles.com/p/articles/mi_m0BJI/is_8_31/ai_76758565
- Mayo Clinic: Hip Replacement, Relieve Pain and Improve Mobility http://www.mayoclinic.com/health/hip-replacement/AR00028
- National Heart Lung & Blood Institute: Facts About Angioplasty http://www.nhlbi.nih.gov/health/public/heart/mi/angioplasty_dci.htm
- Your Health Information Center: Elective Procedures http://www.yourhealthinfocenter.com/information.php