Those who are interested in a hair transplant often ask themselves whether health insurance companies will contribute to the costs. You can find out here.
Will the health insurance pay for my hair transplant?
Does the health insurance cover the costs of my hair transplant? We are regularly asked this question during our consultations. Unfortunately, we then have to tell the patients that cosmetic surgery is generally not included in the service catalogue of the statutory and private health insurance companies. Hair transplants are seen as aesthetic cosmetic surgery. As a rule, there is no medical indication for such operations – they are therefore not medically necessary. This means that the health insurance company is not obliged to cover the costs of such operations or to contribute to them with a subsidy. Only if you can argue skilfully is there a tiny hope of getting a small subsidy as a gesture of goodwill from your health insurance company.
When do health insurance companies contribute to the costs of cosmetic surgery?
If it is proven that cosmetic surgery is necessary for medical reasons, the health insurance company is obliged to cover the costs. When is this the case? For patients who are no longer able to go about their normal daily lives in their current situation. The typical case of a medically necessary cosmetic operation is, for example, a breast reduction. Since an oversized breast often causes relevant back problems etc.
In some cases, these limitations of everyday life can also be those caused by mental illness. The prerequisite is always that the situation can only be improved by means of aesthetic surgery. For your hair transplant, this means: If you suffer from a mental illness due to your hair loss and this mental illness restricts you in your everyday life – only then you have a chance of getting your health insurance to cover the costs. But do not expect too much. After all, a wig is sufficient for most health insurance companies – even if you have no hair left after an accident or illness.
Claim for reimbursement
The medical indication (i.e. whether the operation is necessary) for a plastic-aesthetic procedure must be determined by a specialist. This specialist can then submit a request to the health insurance company for reimbursement of costs. For the doctor, it is of decisive importance whether the physical limitation is normal or whether the patient is suffering from a pathological effect. The health insurance company will then have its own medical opinion drawn up. For this medical opinion, the patients are usually also examined by a doctor from the medical service of the health insurance company. Then the insurance company decides on the basis of its guidelines whether the conditions for the assumption of costs are fulfilled.
Ex gratia arrangement for cost sharing in cosmetic surgery
We have researched the Internet for you. These are possible exceptional cases in which health insurance companies are most likely to agree to a goodwill arrangement to share the costs of an aesthetic operation:
- after burns
- following an accident at work
- for mental diseases
In order to receive a cost sharing on goodwill of the health insurance company, the person concerned must describe his or her special situation and submit corresponding receipts and certificates. The chances that the insurance company will meet your needs are quite small, but they vary considerably from one health insurance company to another and from case to case. If you believe that your chances of success are good, we will be happy to provide you with a cost estimate for presentation to your health insurance company.
Have you perhaps already had experience with a health insurance company in the field of hair transplantation or cosmetic surgery in general? You are welcome to tell us about your experiences. You will help us to advise and inform our patients even better!