Health insurance companies cover a variety of surgeries and medical procedures. However, most insurance companies won't cover surgery costs for voluntary or cosmetic procedures that aren't medically necessary. Policyholders can often determine which surgery costs are covered by reviewing the certificate of coverage. Information about covered procedures and exclusions should give policyholders a good idea whether the procedure they are considering is covered or not. Exclusions and benefits vary by insurer, plan and geographic region. In spite of these exclusions, physicians can sometimes find ways to cover surgery costs by recommending surgeries for different reasons.

Procedures designed to make patients look or feel better, such as plastic surgery, are typically not covered, but the cost of reconstructive surgery and corrective procedures may be reimbursed if the surgeon is correcting a congenital condition, physical deformity or abnormality caused by a disease, tumor, infection or physical trauma. While most health insurance companies won't pay to insert or remove breast implants for purely cosmetic reasons, they may cover all or part of the procedure if it is required to make a person look normal or restore their natural figure as part of reconstructive efforts.

Eye surgery for cataracts, astigmatisms and other conditions that impair a patient's vision may or may not be covered. Eye surgery and advanced surgical procedures are often deemed medically unnecessary if there is another way to correct the problem, such as wearing glasses. These conditions bring up a variety of insurance problems. For example, many insurance companies cover surgery costs for basic procedures to correct cataracts, but they won't cover high-tech or so-called premium procedures like LASIK surgery, which are more expensive.

Weight loss procedures and bariatric surgery to reverse obesity, including implanting a LAP BAND System or undergoing a gastric bypass, are part of an insurance gray area. Many health insurance companies have exclusions for surgical weight loss procedures even in obese patients. What many policyholders don't know is that doctors can recommend weight loss procedures to correct high blood pressure, sleep apnea and covered conditions. The line between medically necessary and unnecessary is very small. For example, many plans cover surgeries to correct varicose veins but not spider veins.

Before authorizing surgery costs, insurance companies require proof that the procedure is medically necessary. Protocols to establish medical need include physical exams, ultrasound and medical imaging. Surgery costs include operating room fees, surgeons' tariffs, anesthesia and follow-up care. Insurance companies can deny coverage for follow-up appointments that fall outside standard 90-day post-operative limits. Before scheduling a surgical procedure, ask the plan provider whether approval is required, how much of the procedure is covered and whether a preferred provider must perform the procedure.