Nose, chest or tummy-tuck surgery: these costs are covered by health insurance
Whether breast enlargement, nose correction or liposuction: beauty is becoming a consumer good. This comes at a cost. Health insurance only rarely pays for cosmetic surgery.
08.07.2022
iStock / shironosov
1. How much does cosmetic surgery cost?
The cost of cosmetic surgery depends on many factors. For example, on the part of the body, the extent of the procedure, the surgical technique or the aftercare. The prices also vary greatly depending on the medical service provider.
Compare providers and get multiple quotes. Pay attention to how the providers bill for additional services (consultation, aftercare etc.).
Nose and breast surgery: costs in Switzerland
Breast surgery in Switzerland costs between around 5,000 and 15,000 francs. Rhinoplasty is available from approx. 6,000 francs and can cost up to 12,000 francs.
2. When does health insurance pay for cosmetic surgeries?
Whether health insurance covers the costs of cosmetic surgery depends primarily on the reason for treatment. Supplemental insurance will cover the costs under certain conditions. The health insurance company takes personal circumstances in individual cases into account when deciding whether or not to cover the costs.
3. What does basic insurance pay towards cosmetic surgery?
Basic insurance only covers the costs of medically necessary treatments in accordance with the Federal Health Insurance Act (KVG). Health insurance does not pay for purely cosmetic procedures without a medical problem — for example, a tummy tuck for aesthetic reasons.
Treatments are medically necessary if there are regular physical or mental symptoms of a pathological nature . The intervention must aim to improve the symptoms.
Check with the health insurance company beforehand whether your procedure is covered.
The insurance company will check the health impairment on the basis of the medical documents. Request a confirmation of coverage.
You will need a cost estimate from your surgeon for this. Include this in your application your health insurance company to cover the costs. Attach detailed documentation to the application: e.g. photo documentation and reports of treatments already received.
In the event of a dispute, contact the ombudsman service for health insurers.
Breast surgery in Switzerland: when are costs covered by health insurance?
Many breast reductions are medically necessary. After all, an excessively large bust can cause health problems. An operation is then usually covered by basic insurance. The condition for this is that at least 500 grams of tissue per side must be removed. A breast augmentation, on the other hand, is usually not paid for by basic insurance.
The health insurance pays for breast surgery for psychological reasons only in particular cases. In this case, an independent medical examiner will check whether there is a pathological problem. The psychological complaints must be considerable and prevail over other (especially aesthetic) motives.
After cancer treatment, basic insurance covers the costs of breast reconstruction. It covers enormous aesthetic impairments after an accident or illness on particularly sensitive parts of the body (in this case the breast).
The aim of the operation is always to eliminate breast asymmetry. Therefore, in principle, the reduction of the healthy breast is also covered by basic insurance. The detailed provisions are set out in the Health Insurance Benefits Ordinance.
Does health insurance cover the costs of a nose job?
Health insurance usually does not pay for aesthetic corrections such as the alignment of the nose. The situation is different if the nose correction is performed because of functional problems. Strictly speaking, this is not a cosmetic operation. Here, too, you should always obtain a confirmation of coverage before the operation.
4. Which supplemental insurance covers the costs of cosmetic surgery?
Some health insurers offer supplemental insurance policies that cover cosmetic procedures. They cover part of the treatment costs — but also exclude many services.
The general terms and conditions of insurance (GTC) specify the specific cosmetic treatments to which the supplemental insurance contributes (e.g. breast surgery, liposuction) and what the criteria are. For certain treatments , for example, an age limit applies (e.g. protruding ears up to the age of 20). Therefore, make sure to read the range of services offered for plastic surgery through carefully.
What do I have to consider about supplemental insurance for cosmetic surgery?
You can only take out supplemental insurance after a medical examination. Insurers do not have to accept you for such policies and can also stipulate provisos.
Coverage for cosmetic surgery is usually offered as part of an supplemental outpatient insurance package. A price cap as well as the extent of the cost share are defined.
5. Is it worth taking out supplemental insurance for cosmetic surgery?
Taking out supplemental insurance just for a cosmetic surgery is not worthwhile in many cases. For one thing, it usually doesn't pay out. And if it does, it will only cover part of the costs and up to a certain maximum amount.
Moreover, possible waiting periods must be observed. In other words, you have to wait before you receive benefits. The duration of the waiting period is specified in the contract.
6. How are follow-up costs of cosmetic surgery insured?
Medical complications are part of the risk of surgery. In Switzerland, you are covered for this by compulsory health insurance. It bears the costs of any medically necessary follow-up treatment. You only incur the costs of the deductible, the coinsurance and, if applicable, the hospital cost contribution.
Basic insurance does not pay for purely cosmetically undesirable surgical results such as breasts of unequal size or asymmetrical lips.
In Switzerland, there is no separate insurance for follow-up costs. Basic insurance covers the costs of medically necessary follow-up treatments.
This article was first published on 08.07.2022
