Is Non-Surgical Facial Rejuvenation Treatment Covered by Insurance?

While it would be convenient if cosmetic procedures were covered by health insurance, providers typically categorize BOTOX® Cosmetic, dermal fillers, and skin resurfacing treatments as aesthetic enhancements, which are not considered medically necessary. This blog will explore the line between purely cosmetic treatments and medically related aesthetic care, as well as other ways to manage the cost of beauty and skin enhancements.

4 Min

How Beneficial Are Non-Surgical Cosmetic Treatments?

Non-surgical facial rejuvenation procedures like injectables, laser therapy, chemical peels, and advanced microneedling treatments have gained popularity as effective ways to restore a youthful appearance without the downtime associated with surgery.

While less invasive aesthetic treatments have evolved greatly, with many techniques now delivering results that rival surgical options, many come with hefty price tags.

Does Insurance Ever Cover Facial Rejuvenation Treatments?

Since insurance companies only cover procedures that are deemed vital for health and functionality, purely aesthetic treatments are typically paid out-of-pocket. However, patients still commonly ask if their treatments could be covered by health insurance. In most cases, the answer is no—insurance doesn’t cover non-essential cosmetic procedures.

What About Non-Surgical Skin Treatment With FFS or FMS?

Insurance coverage for non-surgical gender-affirming treatments varies by plan, state, and employer. Some insurance companies even consider surgical facial gender-affirmation procedures to be cosmetic and don’t cover them.

• Commercial Insurance: Covers most gender-affirming care, but many consider facial procedures as cosmetic, and most don’t cover non-surgical treatments.
• Medicare: Covers medically necessary gender-affirming care, not cosmetic procedures like facial feminization.
• Medicaid: Some states offer gender-affirming coverage, others don’t. None cover non-surgical procedures.
• Employers: Some employers, like Google, Microsoft, and Nike, offer trans-inclusive health insurance coverage that may have more flexible terms for non-surgical rejuvenation.

Cosmetic Treatments Used for Medical Reasons

While facial rejuvenation treatments are rarely covered, some situations may qualify for partial or full insurance coverage if they serve a medically necessary function. These include:

BOTOX® for Medical Conditions

BOTOX® is well known for reducing facial wrinkles, but it is also FDA-approved for several medical conditions. In these cases, insurance may provide coverage:

• Chronic Migraines: BOTOX® can be prescribed for patients who suffer from severe, recurring migraines, and many insurance plans cover the cost of injections.
• Temporomandibular Joint Disorder (TMJ): BOTOX® can help relieve jaw tension and muscle pain associated with TMJ dysfunction, potentially qualifying for coverage.
• Excessive Sweating (Hyperhidrosis): BOTOX® injections in areas such as the forehead or underarms are sometimes covered if hyperhidrosis significantly impacts daily life.

Laser Resurfacing for Medical Skin Conditions

Certain laser skin treatments may be covered by insurance if they are used to treat medical concerns rather than cosmetic issues. Examples include:

• Scarring from burns or trauma: If laser resurfacing is used to improve skin function or reduce severe scarring that affects mobility or comfort, partial coverage may be possible.
• Birthmark removal: Certain large vascular birthmarks (like port-wine stains) may be considered medically necessary to treat, especially if they cause complications.

Reconstructive Procedures After an Injury or Surgery

Patients who have undergone facial reconstruction due to trauma, burns, or cancer treatment may qualify for some non-surgical rejuvenation treatments to restore facial symmetry or skin integrity.

Fat grafting or dermal fillers may be covered in cases where they are used to correct genetic abnormalities or injuries rather than for aesthetic purposes only.

Is My Treatment Covered by Insurance?

Look for a provider who will negotiate with your insurance provider to see if any gender-affirming treatments or surgeries are covered. Restore Medical Center coordinates the insurance process as a value-added service for each patient. They are now contracted with Cigna and Aetna insurance networks, increasing the likelihood of gender-affirming care being partially or fully covered by patient insurance plans. If you think your treatment may qualify for insurance coverage:

• Consult with Your Provider: Speak with your plastic surgeon, dermatologist, or aesthetic professional to discuss the medical necessity of the treatment.
• Check Your Insurance Policy: Contact your insurance company for clarity about their guidelines and criteria for coverage.
• Obtain Necessary Pre-Authorizations: Some procedures require pre-approval from your insurance company before treatment.
• Submit Documentation: Medical records, doctor’s notes, and photos may be required to prove medical necessity.

Alternative Payment Options for Non-Covered Treatments

For non-surgical facial rejuvenation treatments that are not covered by insurance, there are several ways to manage costs:

• Health Savings Accounts (HSA) or Flexible Spending Accounts (FSA): Some procedures related to medical conditions may be eligible for payment using pre-tax HSA/FSA funds.
• Payment Plans or Financing: Many plastic surgery offices offer flexible payment plans through services like CareCredit® or in-house financing.
• Membership or Rewards Programs: Certain manufacturers of injectables, like Allē® by Allergan™ (BOTOX® and JUVÉDERM®), offer discounts and rewards for repeat treatments.

Looking for Gender-Affirmation Care in Miami, FL?

Restore Medical Center and our dedicated surgeons are contracted with Cigna and Aetna and provide surgical gender-affirming care and non-surgical facial rejuvenation treatments exclusively for transgender men, women, and non-binary individuals in Miami. Our compassionate team members are your allies throughout your transformation and beyond. Call (305) 865-2000 to schedule your consultation today!