In some cases, health insurance can reimburse cosmetic surgery.
For this, this operation must be considered as restorative surgery and not purely aesthetic. Health insurance can cover all or part of this operation.
What is the difference between reconstructive and cosmetic surgery?
A reconstructive surgery will intervene to repair, as its name suggests, an injury, a burn, a trauma or during a significant weight loss.
Cosmetic surgery will bring an improvement to one or more parts of the body that are deemed necessary to correct visually but which have no impact on health.
What surgeries can be covered?
A non-exhaustive list is available on the health insurance website to find out which reconstructive surgeries can be covered.
Most often, the surgeries necessary for a return to full health are covered.
- Breast reduction procedures if the surgeon removes more than 300 grams on each side,
- Breast reconstruction after breast cancer,
- Abdominoplasty if the skin of the belly covers the pubis,
- Liposuction if it occurs after surgery for obesity such as bypass or sleeve,
- Skin surgery when there has been trauma after an accident, a burn, a scar,
- The significant detachment of the ears,
- Rhinoplasty if there are respiratory disorders,
The management of certain acts of intimate surgery is also possible when there is functional discomfort or pain.
Surgical procedures such as breast augmentation, rhinoplasty without respiratory problems, injections of hyaluronic acid, fat or botox, lifting (face, breasts, eyelids) are therefore not covered.
What are the steps to take before the surgery?
First you have to find a surgeon who practices reconstructive surgery. You can make your choice through word of mouth or, for greater security, go to the website of the health insurance or the order of doctors which lists the list of contracted surgeons.
At the time of the first consultation
The surgeon will examine his patient in order to assess the risk-benefit ratio of a restorative intervention and ensure that there are no contraindications to this intervention. He then gives his patient the prescriptions for any additional examinations and/or a request for prior agreement to be sent to the medical adviser of his health insurance fund by registered letter with acknowledgment of receipt. Once the acknowledgment of receipt has been received by the patient.
The CPAM’s medical adviser has a period of fifteen days to examine the request. If no response is given within this period, this is equivalent to an agreement for reimbursement from the health insurance fund on which the patient depends. The intervention as well as the post-operative follow-up will therefore be paid directly to the public or private contracted care establishment in which the surgery will take place. If social security does not support the entire operation. The rest to be paid can be paid by the mutual insurance company. In this case, you will have to send him a quote and wait for his agreement. The amount of support will depend on the contract taken out and can range from TV to the entire remainder payable for the surgical intervention, including the single room, the accompanying bed or the excess fees of the surgeon.
If the health insurance fund refuses to cover this intervention. An appeal is possible within two months from the date of receipt of the notification of refusal to appeal this decision. Intervention programming. Once the agreements have been obtained, the intervention can be programmed. A consultation with an anesthetist is mandatory before any operation under general anesthesia to ensure that the patient is in good health. He may prescribe additional tests or blood tests, the results of which must be provided at the time of hospitalization. The anesthesiologist will be seen the day before or the morning of the surgery to ensure that everything is going well.
I am passionate about cultural outings, museum visits, exhibitions and music festivals. I write articles on many of these topics. I hope you enjoy reading my content as much as I enjoy writing it. Do not hesitate to submit your news and invite us. We will inform our readers with great pleasure.
—- –
