Your choice of words matters. Minor definitional nuances can have enormous consequences.
Plastic surgery corrects facial and body defects, while cosmetic surgery reshapes healthy tissue to improve appearance. The first is medically necessary, but the second is not.
Patients can use a Healthcare Flexible Spending Account (FSA) as a financing alternative for medically necessary procedures.
An FSA offers many benefits: no credit check, acceptance with bad credit, zero interest, and default protection. Precertification assures approval. See if you qualify.
FSA Financing Alternative
An FSA is not a financing program but has many advantages over a loan or credit card. Many patients can use their FSA to pay for plastic surgery before making contributions, but not all can.
Understand the pros and cons before you decide.
FSA Drawbacks
A loan or credit card is sometimes the only way to finance plastic surgery. An FSA has drawbacks and may not work for everyone as a payment plan.
A personal loan is suitable for those without an FSA, needing over $6,600, or having non-medically necessary cosmetic procedures.
- Patients or their spouses must have access to an FSA at work. Not every employer offers the program, and the self-employed rarely have the option.
- The IRS imposes annual FSA contribution limits of $3,300 per employee. The maximum is $6,600 if both spouses have access through work.
- Patients cannot use an FSA for cosmetic surgery, which reshapes healthy tissue to improve appearance. It must be medically necessary.
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Many online lenders will prequalify you without a hard credit check. They make soft inquiries to see if you pass their initial criteria. If you accept the loan offer, the lender will look closer at your qualifications before making a final decision.
FSA Advantages
An FSA has many advantages over loans and credit cards. Learn how to use an FSA for medically necessary plastic surgery.
Follow these steps to use an FSA for medical expenses.
- Contact the FSA administrator to confirm that your procedure is medically necessary. This step ensures coverage.
- Choose the annual FSA maximum $3,300 contribution during the annual open enrollment at work, usually in November or December.
- Schedule your surgery at the start of the FSA plan year, usually January 1.
- Pay the surgeon with your FSA debit card.
- Your employer must immediately reimburse qualifying expenses, even if you haven’t contributed yet.
No Credit Check
Patients can use an FSA to pay for plastic surgery upfront without a credit check. Employers cannot check their consumer reports or consider their FICO or Vantage score.
No credit check medical financing typically means lenders approve only small amounts to minimize risks. An FSA provides $3,300 to $6,600 to any employee willing to participate.
Bad Credit OK
Patients with bad credit can use an FSA to pay for plastic surgery upfront. Employers must accept all employees, even those with bankruptcy or other negative entries on their consumer reports.
Lousy credit medical financing often means short repayment periods measured in weeks. An FSA gives you up to twelve months to repay.
Zero Interest
Patients can use their FSA to get money upfront to pay for plastic surgery without incurring interest charges. Better yet, they save money on their taxes!
- Medical financing programs charge interest to compensate lenders. Employers cannot charge interest for FSA-qualified expenses.
- Borrowers repay loans using after-tax income. With an FSA, they make pre-tax contributions, lowering their federal, state, and FICA taxes.
Default Safety
Patients can use their FSA for upfront funding without worrying about default. Employers bear the risk if you lose your job.
- Job loss often leads to loan or credit card delinquency, and finance companies may sue. These lawsuits can result in wage garnishment or property liens.
- Your FSA repayment obligations end if you lose your job or quit. Your employer has no legal recourse to recoup the amounts previously reimbursed.
Precertified Approval
No financing company can guarantee a loan or credit card approval, especially without a credit check. However, patients can confirm insurance coverage and FSA reimbursement before scheduling plastic surgery.
You must show that the procedure is medically necessary: it treats an illness or injury rather than improving appearance. Reconstructive procedures for facial and body defects from birth disorders, trauma, burns, or diseases often qualify.
Insurance Precertification
The amount you need to finance will be lower if your health insurance covers the specific plastic surgery. The insurance company does not consider your credit history.
If pre-approved, your out-of-pocket costs will be much lower, and FSA reimbursement will be almost definite.
- You may still need to pay the annual deductible, copayments, and coinsurance. Use an in-network provider.
- Your FSA should cover these costs. The administrator should be satisfied with an Explanation of Benefits showing an approved insurance claim.
Ask the surgeon to submit administrative and clinical information and a letter of medical necessity for precertification. Many of these procedures usually qualify.
- Breast reconstruction is covered if it follows cancer treatment like a mastectomy or lumpectomy or fixes disfigurement from injury or surgery.
- Debridement, skin grafting, and reconstruction are covered for damage from second and third-degree burns.
- Congenital defect repairs qualify when restoring function and correcting deformities like cleft lip and palate.
- Hand surgeries are covered for diseases or injuries that reduce wrist and finger strength, function, and flexibility, like carpal tunnel syndrome, Dupuytren’s contracture, and rheumatoid arthritis.
- Scar revision qualifies if trauma or scar tissue limits movement, breathing, or eyesight.
FSA Precertification
Some patients can use their FSA to pay upfront when insurance denies plastic surgery claims. FSA administrators follow similar rules but are separate entities and can make different decisions.
FSA pre-approval is crucial for procedures often seen as cosmetic. Here are examples of popular surgeries and when they might be medically necessary.
| Necessary | Cosmetic | |
|---|---|---|
| Rhinoplasty | Correcting a deviated septum improves breathing, as in chronic nasal obstruction. | A person seeks a smaller, sleeker nose purely for aesthetic preference. |
| Sono Bello | Removing a large lipoma improves function, reducing pain or mobility issues. | Removing fat with a laser solely for a slimmer silhouette. |
| Brazilian Butt Lift (BBL) | Reconstructing gluteal tissue after trauma, like a severe injury. | A person seeks a fuller backside purely for cosmetic appeal. |
| Tummy Tuck | Repairing abdominal muscles weakened by pregnancy, improving core function. | A person wants a flatter stomach solely for aesthetic reasons. |
| Breast Augmentation | Reconstruction after a mastectomy, restoring form post-cancer. | Women enhance their boobs for appearance, absent any health condition. |
| Mommy Makeover | Repairing severe diastasis recti, improving abdominal function post-childbirth. | Mothers seek a perkier bust or flatter stomach purely for looks. |
