Is cosmetic or elective surgery reimbursable?
Any procedure (including cosmetic surgery) that is directed at improving the patient’s appearance and doesn’t meaningfully promote the proper function of the body or prevent or treat illness or disease would not be eligible for reimbursement. There is an exception, however, for procedures necessary to ameliorate a deformity arising from congenital abnormality, personal injury from accident or trauma, or disfiguring disease. These may be reimbursable with a physician’s letter of certification recommending the procedure to treat a specific medical condition. Your doctor may provide you with certification on letterhead from their office, or you may provide this Letter of Medical Necessity form for your doctor to complete.