Breast Augmentation and Tummy Tuck are Not Covered by Health Insurance

According to a recent Fox News story, four US women were arrested for an insurance scam where they billed the Culinary Union’s health insurance program for cosmetic procedures performed in Mexico. Two of the women were from Las Vegas and the other two from California. The four have been charged with numerous offenses including mail and health care fraud.

One of the accused, Rebeca Acosta, allegedly arranged meetings with potential cosmetic surgery patients, telling them the insurance program would cover the expenses of such procedures as breast augmentation and tummy tuck surgery if the patients agreed to pay an upfront fee. The procedures were performed in Mexico and claims were submitted to the health insurance program. According to the article, $4.9 was billed to the company for "out of country emergency procedures."

Except in cases of reconstructive surgery, such as breast reconstruction after mastectomy, breast augmentation is considered elective, and therefore, not covered. Tummy tuck, or abdominoplasty, is an elective surgery as well. Though insurance will not cover these procedures, most plastic surgeons offer financing options. For more information on actual financing options for breast augmentation and abdominoplasty, Boston plastic surgeon Dr. Moss offers information on his website.