If facelift goes awry: Backup insurance

  • Article by: MAURA LERNER , Star Tribune
  • Updated: September 20, 2011 - 11:18 AM

Dr. James Grotting is a cosmetic surgeon who likes to talk about things going wrong.

You'd be surprised, he said, how often a routine facelift or tummy tuck can lead to complications. Infections. Blood clots. Shock. Even heart attacks.

Grotting, a Minnesota native who lives in Alabama, saw a business opportunity here. Some health insurance plans refuse to pay for the complications of cosmetic surgery, he said. So he started a company, CosmetAssure, in 2003 to do it himself.

The company covers a list of about a dozen complications for 17 cosmetic procedures. So if a breast lift causes internal bleeding, or a nose job triggers an infection, the insurance would cover the extra costs of medical care.

"It happens a lot more than our literature would suggest," said Grotting. He estimates that something goes wrong in 1 in 61 cosmetic surgeries, based on the claims paid by his company.

Last month, CosmetAssure started offering its "unique" insurance in Minnesota -- not to patients, but to plastic surgeons.

In this case, the doctors would pay a premium, $165 to $240 a patient, to give their clients peace of mind (and presumably raise their fees to cover the cost). "It really expands the safety net for patients," said Grotting.

But what about his premise? In Minnesota, most health plans probably do cover such complications, even if they don't cover the cosmetic procedures themselves, said Eileen Smith, of the Minnesota Council of Health Plans. But she said plans may differ, so it's worth checking.

Grotting insists that, across the country, some insurers routinely deny such claims. They might cover some complications, such as heart attacks, but not others. A lot of policies, he said, leave the question blurry.

But even his company draws the line: It won't pay to redo surgery for an unhappy customer. "That," he said, "would be a can of worms. There's just no end to what some patients might want."


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