2023-06-24 10:23:50
Under certain circumstances, private health insurance can cover cosmetic surgery such as laser eye surgery, breast augmentation, breast reduction, breast lift, hair transplant, nose job, ear job, liposuction and eyelid surgery. However, there are various requirements for the assumption of costs, which may depend on the individual insurance policy. Below you will find an overview of the individual cosmetic surgeries and their requirements:
Cost assumption of the PKV of the eye laser
The private health insurer can bear the costs of laser eye surgery, e.g. with ReLEx SMILE, Femto-LASIK, LASIK, Trans-PRK, PRK or LASEK, if there are medical reasons that require an improvement in vision. These include, for example, a high level of ametropia or certain eye diseases. A prior medical examination and referral is usually required.
Coverage of the cost of lens implantation
Under certain conditions, the PKV can also cover the costs for a lens implantation, e.g. monofocal lenses, multifocal lenses, phakic lenses or femto-phaco. The medical necessity of lens implantation must be confirmed by a medical diagnosis. Before the procedure, it is advisable to clarify the individual requirements of the private health insurance and, if necessary, to obtain prior approval. It is important to review the specific terms of insurance and submit all required documentation for coverage in order to get clarity on the financial coverage of the lens implantation.
PKV assumes the costs of dental implants
As a rule, certain requirements apply to the assumption of the costs of dental implants by private health insurance. Dental implants are generally regarded as an aesthetic or prosthetic measure and are therefore not automatically included in the basic benefits of private health insurance. In order to apply for reimbursement of costs, it is often necessary to take out special supplementary dental insurance.
A notice: Dental insurance can cover a variety of dental health benefits, including the cost of dental implants. However, the exact conditions and coverage amounts vary depending on the insurance provider and tariff. When taking out supplementary dental insurance, it is important to carefully check the scope of benefits, the waiting times and any exclusions.
PKV will cover the costs of breast augmentation
In some cases, private health insurance can cover the cost of breast augmentation if there are medical reasons. This can be the case, for example, if there is a congenital breast malformation or if breast reconstruction is required after a mastectomy. A doctor’s evaluation and a medical necessity are usually required.
PKV will cover the costs of breast reduction
For a breast reduction, the PKV can, under certain conditions, consider covering the costs. As a rule, a medical indication is required that indicates health problems and impairments caused by an overly large breast. This can lead to back or shoulder problems, for example. A medical examination is often required before the costs are covered in order to determine the medical necessity. It is advisable to coordinate with the PKV in advance and to submit all relevant medical documents in order to clarify whether the costs will be covered.
Breast lift reimbursement
A breast lift can also be covered by private health insurance under certain circumstances. The focus here is on correcting sagging or sagging breasts. Medical reasons can be psychological stress or physical complaints associated with the appearance of the breast. As with breast reduction, it is important to prove a medical indication and to coordinate this with the PKV in advance. A medical assessment and the submission of relevant medical documents can help to apply for and guarantee the assumption of costs.
PKV pays for the hair transplant
The PKV can cover the costs of a hair transplant if there is a medical indication. This can be the case with certain conditions such as hair loss due to scars or alopecia areata. A prior medical examination and recommendation is usually necessary.
PKV will assume the costs of nose correction and ear correction
The PKV can cover the costs of a nose correction or ear correction if there are medical reasons. This can be the case if there is a nose or ear malformation that leads to breathing difficulties or mental stress. Prior medical evaluation and medical necessity is usually required.
Liposuction covered by PKV
Liposuction may be covered by private health insurance in certain cases if there is a medical need. A prior medical evaluation and submission of appropriate medical documentation is usually required to apply for coverage. It is important to check the individual insurance conditions and, if necessary, coordinate with the private health insurance company in order to get clarity about the requirements for the assumption of costs.
In both cases, it is important that the individual requirements and guidelines of the PKV are observed. The exact conditions may vary depending on the insurance policy and tariff. It is therefore advisable to obtain comprehensive information about the insurance conditions in advance and, if necessary, to make a written request for the assumption of costs.
If you would like to ask your PKV about the assumption of costs for cosmetic surgery, please note the following points:
Prior arrangement: Before having the cosmetic surgery, contact your PKV. Ask about the exact requirements for the assumption of costs and which documents or proof you have to submit.
Medical justification: Prepare all relevant medical documentation proving the medical necessity of the cosmetic surgery. This may include medical reports, test results or other relevant medical documents.
Written inquiry: Submit your request in writing to your PKV. Provide all relevant information about the planned cosmetic surgery and submit the required documentation. Ask for written confirmation of coverage or more information if additional steps are required.
Clarification of details: Ask about the exact costs covered by private health insurance, as well as possible deductibles or restrictions. Also clarify whether pre- and post-treatment or possible follow-up costs are covered.
For people who are currently looking for private health insurance (PKV), there are a few aspects to consider:
scope of services: The private health insurance comparison, carefully check the scope of services of the various private health insurance offers. Make sure the cosmetic surgeries you want like laser eye surgery, breast augmentation, breast reduction etc. are covered. Read the insurance conditions carefully and pay attention to any exclusions or limitations.Medical Necessity: Note that private health insurance usually only covers the cost of cosmetic surgery if there is a medical need. This means that medical evidence or an assessment may be required to apply for coverage. Find out in advance about the specific requirements of the PKV regarding medical indications for cosmetic surgery.waiting times: Check the waiting periods in the insurance contracts. Some private health plans may require a specific waiting period before cosmetic surgery is covered. Make sure you understand the terms regarding waiting times and take them into account when making your decision.Additional insurance: As an alternative to private health insurance, you can also consider supplementary insurance that specifically covers cosmetic surgery. These supplementary insurances often offer specific benefit packages for aesthetic procedures. Here, too, carefully compare the various offers and pay attention to the scope of coverage and requirements.
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