Does Insurance Cover Plastic Surgery to Remove a Scar After Getting a Surgery?

Many patients wonder if their insurance will cover plastic surgery to remove scars that have formed following a surgery. Unfortunately, the answer is often no, unless the scar is medically necessary and affects daily functioning.

Medical Necessity and Insurance Coverage

Insurance policies are designed to cover medically necessary procedures that improve your quality of life or address genuine health concerns. If a scar is causing physical or psychological distress and it might be impacting your ability to perform daily activities, you might have a case for insurance coverage. However, the burden of proof lies with you to demonstrate that the scar is medically necessary and not purely cosmetic.

For example, I had to undergo surgical manipulation after knee replacement surgery to “unlock” internal scar tissue. This procedure was covered by insurance because it was medically necessary to alleviate pain and improve mobility. However, the exterior scar from the knee replacement surgery was not covered and had to be addressed through other means, such as scar revision techniques.

Scar Revision Options

For non-medically necessary scars, insurance coverage is less likely. In these cases, scar revisions are generally considered cosmetic procedures, and they may not be covered by insurance. However, there are effective treatment options available to improve the appearance of scars.

One popular option is the use of Bio Oil. This product has been praised for its ability to soften and improve the appearance of scars. I have personally used Bio Oil on various scars, including a thyroid scar from a wrist injury and a scar from having a cactus needle removed. The results have been impressive, with the scars either becoming hard to see or significantly lighter in color, leading me to highly recommend this product.

Proactive Scar Care Strategies

While insurance may not cover plastic surgery for scar removal, there are several proactive steps you can take to care for your scars and reduce their appearance. Here are a few strategies:

Apply Scar Gels and Oils: Products like Bio Oil, silicone gel sheets, and hydrogel sheets can help improve the texture and appearance of scars over time. Regular Massaging: Gently massaging the scar with a moisturizing lotion or oil can help improve its texture and even out its color. Protecting from Sun Exposure: UV rays can exacerbate the appearance of scars. Using sunscreen and wearing protective clothing can help minimize the sun's impact. Follow Professional Advice: Dermatologists and plastic surgeons can provide advice and treatments tailored to your specific needs.

Conclusion

In summary, insurance coverage for plastic surgery to remove scars after surgery is unlikely unless the scar is medically necessary. Non-medically necessary scars are generally considered cosmetic and may not be covered by insurance. However, there are various treatment options available, such as using products like Bio Oil, that can help improve the appearance of your scars.

If you are considering scar revision, consult with a healthcare provider to determine if your specific case might qualify for coverage as a medical necessity. Additionally, explore over-the-counter options and consult with a dermatologist or plastic surgeon to find the best approach for your unique situation.