People on RealSelf have told us that figuring out how to pay for a cosmetic or elective treatment is one of the most confusing aspects of getting plastic surgery.

To demystify this often complicated process, we went straight to the best source — plastic surgery practice managers who deal with this stuff every day. Practice managers can be your best friend when it comes to understanding financing. They explain the procedure’s costs after your consult, often breaking it down line by line, and give you payment options.

We asked two top plastic surgery centers’ practice managers to explain financing. These experts were more than happy to share the ins and outs of the costs, what’s covered, and their tips to get outside financing help if you need it.


Know what you can afford

Researching a surgery — learning about the procedure, healing times and more — is so important when picking a doctor. One of the most important things to know? A ballpark figure of what it’s going to cost you. As most surgeons will tell you, this is not the best time to go bargain hunting.

Some medical practices list prices, or will give you an average cost on the phone. Some won’t. But it’s always important to ask to avoid sticker shock or wasting time.

Post-consult, you’ll likely sit down with the practice manager to go over costs.

“I print out the total cost, and I always say, ‘Your total is here,'” said Sarah Gafvert, patient coordinator at Dr. Michael Ciaravino‘s office in Houston. “You’ve got our practice fees, facility and anesthesia fees. The bottom line can be a bit of a shock, so I break it down so they see exactly what they’re getting. … After that, if they want to schedule, I take a deposit.”

Don’t forget to ask for help, or scale back on your expectations, if you need to.

“Sometimes patients want a lot of things done, and when it comes time to think about paying for it all they realize they have to make some decisions,” says Lisa Federico, of Dr. John Paul Tutela‘s office in Livingston, New Jersey. “I help patients figure out what is feasible for them and what they really want, i.e. if they are deciding between a breast augmentation and a tummy tuck, which matters more.”

Heads up: Many practices require payment in full before your surgery. And you will probably need a physical from your primary care doctor’s office for medical clearance, plus painkillers and antibiotics post-surgery. Federico says that sometimes insurance will cover those costs, sometimes it won’t, but you need to factor that medical care into your total costs.


Related: Nearly 4 in 10 plan to spend tax refund on plastic surgery.


Your credit matters

Gafvert says one of the most common questions is if they offer “in-house financing.” Like most offices, they do not, but they do work through healthcare credit card companies, like CareCredit and Alphaeon Credit.

If you are seeking credit, the office will often send you home with instructions on how to apply.

“Right off the bat, if they’re approved it’s instant online,” Gafvert says. “The application often takes five minutes or less. It asks a few basic questions about income, whether you rent or own your home, that sort of thing. What I have been told, if you get a notice that says, ‘We will contact you within seven to 10 days,’ to let you know about your approval, it’s usually going to be declined.”

If you are approved, your healthcare financing company will issue you a 16-digit number you can use immediately like a credit card.

Gafvert says that if someone is denied by CareCredit, she refers them to Alphaeon, a newer company that tends to be a “little more lenient” when it comes to credit approval.

“I’ve had people be really honest, saying, ‘I’m going through a divorce, and it’s ruined my credit,'” she says. “They should contact their credit card companies, find out why their credit score is in trouble and ask them how to improve it. Work at it for six months, and then you can try again.”


Be realistic about payments

Approved? That’s great, but there’s some more math to consider: Your payments.

Most healthcare financing companies have a payment calculator on their sites to help you determine what payment plan will work for you. CareCredit, and others, offer the first six months interest free. But that’s only if you pay off your procedure in those six months.

“If you default, that interest rate jumps up pretty high,” Gafvert says. “They will also retroactively charge you interest on those six months. If you want to do the six months, and there is any chance you won’t be able to do it, don’t do it. Pick one of the longer-term payment plans. You can always pay it off early.”


‘Yes, we price match’

Price matching? Plastic surgery isn’t like buying a car or an appliance, but Federico explains why Dr. Tutela’s office offers to match prices.

“Cosmetic surgery is going to cost you, plain and simple,” says Federico. “It is more about the doctor, because you are going to be seeing your doctor every week and closely communicating with them, and you want someone you can trust and feel comfortable with, and who you think will give you the best results.”

Federico says they won’t match an unrealistic offer or plastic surgeons working in much less expensive markets than New York and New Jersey. However, she says that if they send her a written estimate from a board-certified plastic surgeon in the same area for the exact same procedure (and everything it includes, like OR and anesthesia), “we will price match any estimate.”

“We price match so when you come in and meet Dr. Tutela and feel comfortable and in good hands and that you will get amazing results, you don’t have to go to the doctor who offers you [the same procedure] for a thousand less. … Never bargain shop for a surgeon.”

Find a doctor today.