Does health insurance cover rhinoplasty?

Maybe you have been unhappy with your nose for as long as you can remember, or perhaps you are having difficulty breathing; either way, a rhinoplasty or nose reshaping may be an option for you.

A rhinoplasty can change many things about your nose, including your nose size (in relation to your face), nose width at the bridge, the size and position of the nostrils, and nose profile (by downsizing visible humps, bumps or depressions on the bridge).

A rhinoplasty can also reshape the nasal tip, improve the appearance of large, wide or upturned nostrils and correct nasal asymmetry. From a functional standpoint, a rhinoplasty can correct certain breathing difficulties such as those due to a deviated septum. Rhinoplasty is also an option for certain birth defects or noses that have been injured in car or sports accidents.

Most insurance companies will not pay for nasal surgery performed for cosmetic reasons. That is not to say that health insurance never covers rhinoplasty. Occassionally, they will cover surgery performed to correct post-traumatic deformities, to modify the nasal passage to aid in breathing, or another medical necessity. Insurance will, however, pay for the portion of a rhinoplasty that is done to improve your breathing – i.e., correcting a deviated septum (septoplasty) or reconstructing collapsed breathing passages (spreader grafts). You should check with your physician to see if he accepts insurance and whether or not you are a candidate for these types of procedures. If you have had health problems caused by your nasal passages, and septoplasty / rhinoplasty are recommended to correct the condition, your insurance may cover the cost of the procedure.

If, on the other hand, you are seeking rhinoplasty for purely cosmetic reasons, odds are heavily against having the procedure covered by your medical insurance.

You can ask your surgeon about filing for insurance. Only your physician or surgeon can submit to the insurance company the reasons why you are having rhinoplasty surgery. As mentioned before, those procedures which are not deemed necessary by your insurance company will not be covered. If your physician feels that your rhinoplasty procedure is necessary to improve your health or quality of life they can file the forms required to in order for the insurance company to allow the surgery.

For instance, your insurance will not allow your claim if your primary reason for surgery is improving a nose that is unattractive, too large or crooked. These are considered cosmetic reasons. That is not to say that the rhinoplasty to correct the crooked nose won’t ever be covered. If the main goal of the surgery is to reconstruct the nose from a trauma or developmental abnormality, then it is possible that your insurance company will cover some of the cost. This is most commonly referred to reconstructive surgery and some rhinoplasty procedures are covered when they are considered not merely to improve appearance but to reconstruct a necessary problem. If you are seeking rhinoplasty surgery, there will be prior authorizations and a review period, which must be completed before you can continue.

If the cost for rhinoplasty is too much to pay at once, ask your surgeon about monthly payments. For financing options and tips, continue reading about Patient Financing.

Some of the cost of rhinoplasty can be covered by insurance if the rhinoplasty procedure is related to modifying the nasal passage to aid in breathing, or another medical necessity. You can ask your surgeon about filing for insurance. Rhinoplasty for purely cosmetic reasons is not covered by insurance.
If the cost for rhinoplasty is too much to pay at once, ask your surgeon about monthly payments. For financing options and tips, continue reading about Patient Financing.

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One Response to Does health insurance cover rhinoplasty?

  1. Benton Tarquinio says:

    Nasal surgery (Rhinoplasty Surgery), the most common form of plastic surgery practiced in America today, is a procedure that alters the framework of the nose, manipulating the bone and cartilage structure and the skin to improve the appearance of the nose. It can be used to change the overall appearance of the face from one where the focus of attention was placed on the nose to one where the attention is drawn away from the nose and towards the eyes, a more natural, pleasing occurrence. When the focus of attention is directed towards any other feature on the face other than the eyes, the face is said to be out of “harmony”. Rhinoplasty surgery, when performed correctly, improves the harmony of the facial features.”

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