Insurance Coverage for Correcting Deviated Septum and Crooked Nose?

Insurances do cover for a functional problem as the case with a deviated septum but not all the time. At times they require documentation with an imaging study such as a CT-Scan. You should check with your insurance company to see if your plan covers deviated septum. Some insurance companies exclude procedures, so far I have not come across one that excludes deviated septum.

Generally, insurance will cover the functional portion of your surgery as long as your condition and the degree of nasal obstruction, and alternatives to surgery have been well documented by your surgeon. The insurance company may even elect to cover the nasal fracture portion of your procedure. If the fracture is old, it will likely be treated as a cosmetic condition and coverage is very unlikely. There are still advantages to having your nose fixed the way you want it if you are... more

Medical Insurance has literally become a criminal scheme in which you / your parents/ employer pay a company with the understanding that IF you have a condition listed ON YOUR POLICY they and you will pay a doctor / hospital an agreed amount to correct it. Human nature being what it is all sides cheat or push the envelope. Patients want EVERYTHING to be "covered" regardless of what they / the employer paid without any out of pocket expenses while insurance companies want to... more

Surgery for a deviated septum is typically covered by medical insurance since it is done out of medical necessity. A broken nose is sometimes covered if it is creating a breathing issue whereby both nasal bones are twisted over the upper lateral cartilages or fractured off the nasal bones causing the upper lateral cartilage to be pushed down into the airway, causing nasal obstruction called valve collapse or vestibular stenosis. It might be best to wait until you have completed playing... more

Insurance will typically cover the "reconstructive" component of the surgery which is the septoplasty, to improve your breathing. Insurance will not typically cover the "cosmetic" portion, which is the crooked nose straightening. Coverage varies greatly according to your specific health care plan, so discuss this in detail with your surgeon and insurance company to get "preauthorized". This will determine which portion and how much of the surgery they will... more

Hi Tioga, The physician's here have answered your question very well.  By next summer, things may be very different, you may have to ask Barak Obama whether your surgery will be covered.  Be well. Dr. P

Asking us if an insurance company will cover necessary surgery takes a crystal ball. First, for a deviated septum, if it is causing symptoms such as blockage and/or sinus conditions, they might requre that you try non-surgical treatments first. If that fails, they often "cover" this aspect of functional nasal surgery. How much they cover depends on your plan and if your chosen specialist participates in that specific plan. As for your crooked nose, if it was broken many years ago,... more

Today, medical insurance companies do not want to pay for anything. You need to check the company you have and see if it will cover it. Each company is different and has different requirements and hoops they make you jump through before they will pay.

Most insurance companies will not pay for nasal surgery performed for cosmetic reasons. Occassionally, they will cover surgery performed to correct post-traumatic deformities. 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... more

Depending on your insurance and the way your doctor phrases the request for prior authorization, if needed, you might be able to have both done ubnder coverage. But certainly at least the facility fee and anesthesia would likely be covered, pending review, as both the cosmetic and the functional part is done at the same time. There is not set answer, each case has its own unique feature.