HMO & PPO
Both HMOs and PPOs have two categories under which skin rejuvenation treatments may fall:
Medically Necessary Procedure
The majority of rejuvenation treatments will fall under the category
of cosmetic procedure, and as such, will not be covered by insurance
Insurance companies use varying criteria in order to determine if a skin rejuvenation
treatment is to be considered "medically necessary." These
criteria may include one or more of the following:
Lifestyle Disruption: the daily activities of the patient must be disrupted significantly.
Pain: The patient must be experiencing pain as a result of their disorder.
Failure of Conservative Measures: Other methods of treatment have failed to provide adequate relief.
Complications: Complications make it more likely an insurance company will consider a treatment medically necessary.
Medicare will generally not reimburse for these procedures. You will have
to contact your physician to determine whether they are participating
in Medicare and whether your treatment may be covered. Any secondary
and supplemental insurance company will require Medicare to decline
the service before they will consider reimbursement.
Most physicians will offer you a variety of payment methods. Please ask
the physician about payment options during your consultation. For
further insurance information, contact your insurance provider for