Is My Cosmetic Surgery Covered By Health Insurance?

Written By
Megan Apa
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August 1, 2014

The fees for various procedures depend on the extent of work involved, the time required, and whether special instruments are necessary for the surgery. Ask your surgeon about cosmetic surgery financing options and clarify the terms.

In Toronto the Provincial Health Insurance (OHIP) plans do not cover elective plastic surgery. However, surgical procedures aimed at correcting a functional problem might be covered. For instance, the release of the carpal tunnel which can interfere with proper function of your hand is an OHIP procedure.

There are certain guidelines concerning whether your surgery is for cosmetic reasons or to correct a medical problem. Check with your plastic surgeon to learn what can be covered by OHIP. Most provincial health plans will cover all or part of the surgery, if you have an abnormality that needs correction.

Reconstruction surgery that deals with health risks and repairing deformities may be covered. Nose surgery, Rhinoplasty, for example, may be covered by insurance if the purpose of the surgery is not to improve the appearance of the nose but to improve breathing and relieve an obstructed airway because of a previous injury such as a broken nose.

Procedures done for cosmetic reasons are not covered by provincial health plans (such as OHIP) and thus there is a fee associated with them. The fees would depend on such aspects as complexity of the procedure, time required for its completion, number of areas treated and anesthesia offered. Cosmetic surgery is a combination of art and science. Like any two artists will create a slightly different piece of art, no two surgeons perform the same procedure exactly the same way. There are difference in technique, skill, and services offered in addition to the surgery itself. Thus the fees vary from surgeon to surgeon. With this, if you stumbled upon discounts, you should wonder what may have been compromised to compensate for such a dramatic decrease in pricing.

Prices quoted in our clinic represent the total amount (including the surgical costs, anesthesia, nursing, medications, etc), there are no hidden fees. Take into account that these fees are a rough guide, as each patient is different and their needs are different. In order to get an accurate estimate of your surgical fees Dr. Jugenburg would have to meet with you, examine you and discuss your goals with you.