Reconstructive Surgery with Sanitas
Same surgeons, same operating theatres, often the same techniques. Covered if it restores something you lost. Not covered if it changes something you always had.
The distinction that decides everything
Reconstructive surgery restores something that was damaged or lost. It is covered.
Cosmetic surgery changes something that was always as it is. It is not covered.
Same surgeons, same operating theatres, often similar techniques. Entirely different answers on whether your policy pays.
What is normally covered
Breast reconstruction after cancer surgery. Repair after an accident, a burn or a serious wound. Scar revision where the scar restricts movement or causes pain. Removal of skin cancers from the face where the wound needs proper closure. Correction of congenital problems such as cleft lip. Surgery to correct a functional problem – eyelids drooping far enough to obstruct vision is the classic example, and it is covered because it affects sight, not appearance.
What is not
Facelifts, tummy tucks, breast enlargement or reduction for appearance, nose reshaping for appearance, liposuction, and anti-ageing treatments. If the reason is how something looks rather than how it works, expect to pay.
Borderline cases exist and they are decided individually. Breast reduction, for instance, is covered only to remodel the healthy breast after cancer surgery. Reduction to correct large breasts is excluded, even where the weight causes back and shoulder problems.
Getting a straight answer before you commit
The consultation is covered whichever side you fall on, so book it and ask directly. Surgeons in this field have the conversation constantly and will tell you plainly. What you want to avoid is assuming, going ahead, and finding out afterwards.
If the case is arguable, get the surgeon to put the medical reasoning in writing before surgery rather than appealing after it.
Waiting periods
Consultations immediately. Outpatient procedures after 3 months. Anything needing a hospital bed after 10 months. Reconstruction following an emergency, such as an accident, is covered from day one.
See every Sanitas waiting period in one place, including how switching from another insurer waives nearly all of them.
Where the surgeons are
160 clinics across 38 provinces, with 225 named specialists between them – and you can book any of them yourself, without a referral.
- Madrid – 34 clinics, 49 surgeons
- Barcelona – 25 clinics, 44 surgeons
- Vizcaya – 10 clinics, 14 surgeons
- Zaragoza – 8 clinics, 10 surgeons
- Seville – 7 clinics, 12 surgeons
- A Coruna – 7 clinics, 8 surgeons
Ask us and we will check who is near you and what languages they work in.
What you pay
Nothing on a no-co-payment plan for reconstructive work once waiting periods have passed. A fixed amount per appointment on a co-payment plan. Cosmetic work is yours to fund either way, though network prices are often better than open-market ones.
Find a reconstructive surgeon near you
Browse reconstructive surgery in the Sanitas directory – by province, with addresses, phone numbers and a map.
