Paying for cosmetic surgery can cut deeply into your budget
By Robbie Woliver • Bankrate.com

So, you decided you want to look like Vanessa Williams or Mel Gibson. Or maybe you just want to do a little something about a receding hairline or the bags under your eyes, and you're ready to go under the knife to do it.

Nose jobs, breast augmentation and other popular beauty enhancing procedures have transformed cosmetic surgery into a fast-growing area of medicine. As it grows in popularity -- and price -- one of the fastest-growing medical procedures is moving from a cash business into a credit/finance market.

It may be tough to resist when you're asked, "Don't you want to be perfect?" But how will you pay for it?

Cash is king, but most plastic surgeons accept major credit cards, and finance companies are rapidly expanding in this field.

"There are an increasing number of businesses doing this kind of lending and financing," says Dr. Mark Solomon, a suburban-Philadelphia cosmetic surgeon.

Solomon says that one-third of patients who come for a consultation don't return because of the cost or because they cannot get financing.

If you choose the financing-company option, check out the money details as carefully as you scrutinize the surgeon and the surgery. Not all plastic surgery financing companies work the same way.

A lot of these companies are referral services, many currently found on the Internet.

"They hook you -- prequalify you -- and then they send you lists of doctors who are part of their program, who are often paying heavy subscription rates," says Dr. Bruce Cunningham, chief of plastic surgery at the University of Minnesota. "They are becoming the portal to receiving aesthetic surgery in the future."

Cunningham warns patients who use a financing company not to be any less thorough in checking out doctors, facilities or procedures simply because the company is involved.

Coverage not a clear-cut issue
Virtually no cosmetic surgery procedures are covered by health insurance because they are elective. Cosmetic surgery is considered a choice, not a medical necessity. That means that even procedures you feel are essential to maintain or improve your quality of life -- such as the increasingly popular Lasik eye surgery, which costs anywhere from $1,500 to $3,000 per eye -- must be paid entirely out of your pocket.

For a few people, though, there may be some room to maneuver if the surgery falls between the two.

The American Society of Plastic Surgeons says there are "a number of gray areas" in coverage for plastic surgery that sometimes require special consideration by an insurance carrier. These usually involve surgery that may be reconstructive or cosmetic, depending on the situation.

For example, eyelid surgery (blepharoplasty), a procedure normally performed to achieve cosmetic improvement, may be covered if the eyelids are drooping severely and obscuring a patient's vision. Or, nose surgery (rhinoplasty and/or septoplasty) may be covered if it will correct a defect that causes breathing difficulties. Even penile enhancement might be covered if a dysfunction is diagnosed.

You may appeal your insurance carrier's decision if they determine you don't qualify for benefits for reconstructive surgery, or even if you feel the benefits they agreed upon are too small. You may argue an absolute medical need, and your doctor may support you, but don't be surprised that you face an uphill battle.

With elective cosmetic surgery, fees are the sole responsibility of the patient and so are the sometimes-heavy associated costs involved in any hospital stay or lengthy recovery programs.

-- Updated: April 26, 2004