How to Get Insurance to Cover Your Surgery

A comprehensive surgery & insurance planning guide designed to help you better understand the process of pursuing medically necessary surgery through your health insurance.

If you’ve ever wondered, “Will my insurance cover this surgery?” or “Where do I even start?” this guide was created to help you navigate the process with more knowledge and preparation.

Inside, you’ll learn how to:

• Understand the difference between cosmetic surgery and medically necessary surgery

• Recognize the types of medical concerns that may be relevant when discussing surgery with your healthcare provider

• Prepare for your doctor’s appointments and know what questions to ask

• Understand the importance of medical documentation and building a paper trail

• Document recurring symptoms, including rashes, irritation, discomfort and other concerns

• Understand how your PCP, referrals and specialist appointments may fit into the process

• Learn how to research surgeons and verify whether they accept your specific insurance plan and procedure

• Understand in-network vs. out-of-network providers

• Know what questions to ask your insurance company before moving forward

• Understand deductibles, copays, coinsurance and other potential out-of-pocket costs

• Understand what happens when an insurance company denies a request

• Learn the basics of appealing a denial and what documentation may be important

• Understand what a peer-to-peer review is and how it can affect the authorization process

• Understand how primary and secondary insurance may work when you have more than one health plan

• Prepare questions about your surgeon’s approach, expected results and postoperative care

• Understand why asking about aftercare, compression, garments, massages, recovery time and travel before surgery matters

• Learn how medically necessary procedures may differ from cosmetic procedures when it comes to the desired outcome

• Keep track of your research, questions, appointments and important information in one place

Expanded Procedure & CPT Reference

The guide also includes an expanded CPT reference section covering up to 20 commonly discussed procedures, including:

• Panniculectomy

• Abdominoplasty

• Breast reduction

• Breast lift

• Breast implant removal

• Thighplasty

• Brachialplasty / arm lift

• And additional commonly requested procedures

The actual CPT codes and reference information are included inside the purchased guide.

What You’ll Receive

A downloadable digital e-book that you can keep, reference, print and take notes in as you navigate your surgery journey.

This guide is designed to give you the information and questions you need at your fingertips—so you aren’t trying to remember everything discussed during a short consultation or searching for answers one question at a time.

Please Note: This guide is for educational and informational purposes only. Insurance coverage, medical-necessity requirements, authorization criteria and benefits vary by insurance company, health plan, procedure and individual circumstances. Purchasing this guide does not guarantee insurance coverage or approval for any procedure.