Patients have dodged> a proposed tax on liposuction, Botox injections and other elective medical procedures, but cosmetic surgery is still no bargain.
Despite a 12% decline in cosmetic procedures during 2008 (the latest figures available), Americans still spent $11.8 billion on cosmetic surgery, according to the American Society of Aesthetic Plastic Surgery. Congress sought to capitalize on that interest with a 5% tax -- aptly nicknamed the Botax -- but cut it from health reform bills late last year after intense lobbying pressure from doctors and drug makers. Lawmakers estimated the Botax would have pulled in $5.8 billion over 10 years.
The tax would have put extra burden on consumers, considering most procedures are entirely out of pocket already. It is a consumer purchase funded out of the household budget, says Tom Seery, the founder of RealSelf.com, a review and price site for cosmetic procedures. Rarely if ever does insurance pay for that.
While no surgery is trivial and all carry risks many consumers will elect to go under the knife this year. If you're set on Botox injections, a facelift or tummy tuck, here are five way you can cut costs.
Talk to your insurer
Cosmetic procedures for reconstructive purposes after an accident or disfiguring disease are almost always covered, but elective procedures just to improve your appearance rarely are. Still, it s worth asking about, says Dr. Darshan Shah, a board-certified plastic surgeon and the medical director of the Bakersfield Wellness Surgery Center in Malibu, Calif. Insurance companies might be swayed to cover part of the cost if you can prove medical necessity -- say, breathing problems as cause for nose surgery, or a breast reduction to alleviate back pain. They may also cover medically necessary procedures that stem from earlier surgeries, such as a tummy tuck after gastric-bypass weight loss or removing scar tissue after an elective breast augmentation, he says.
Insurers may also permit you to use pretax dollars stashed in a flexible spending account (FSA) or a health savings account (HSA), if they deem the procedure a qualified medical expense. That saves 10% to 35% on out-of-pocket costs, depending on your tax bracket. Aetna, for example, allows FSA reimbursement for collagen injections when they're recommended by a doctor to treat a medical condition, such as severe acne.
Keep an open schedule
If you can be flexible with the timing of your procedure, ask to be put on the doctor s on-call list to grab the spot of a last-minute cancellation. They don t want their operating room to be empty, says Dr. Payman Simoni, a double board-certified plastic surgeon and the founder of Simoni Plastic Surgery in Beverly Hills, Calif. That costs them money in set-up and staff fees paid out in advance. Depending on your procedure, an open schedule could save you 10% to 40%, he says, and you will still have a one- or two-day notice to complete pre-op lab work.
Pay with cash
Doctors pay provider fees as high as 20% on third-party financing, says Shah. Many pass those costs along to patients. Pay in full with cash or a personal check, and you can avoid that extra fee, plus any interest charges from the financing itself. PriceDoc.com lists local surgeons cash prices on elective procedures.
Within cities, many physicians are willing to match a competitor s price, says Dr. Richard Baxter, a board-certified plastic surgeon and the chief medical officer of Calidora Skin Clinics in Seattle. Make sure you re comparing surgeons of similar qualifications and procedures performed in an identical fashion. If prices near home are still out of reach, consider traveling. Prices can vary from city to city, he says.
Don t cut corners
The lowest price isn t the best indicator of quality when it comes to picking a doctor or a procedure. Make sure the surgeon you pick is qualified and has a good reputation, and that the procedure has a track record of good long-term results, says Dr. George Sanders, a board-certified plastic surgeon based in Encino, Calif. Otherwise, you could soon end up back in a doctor s office for another procedure to repair or repeat the first.