Rhinoplasty Q&A
80%
WORTH IT RATING
"Worth It Rating" shows the % of consumer reviewers that stated the procedure was "Worth It" or not. See more RealSelf Worth It Ratings or Add Your Review
1,002 Reviews
Rhinoplastybefore & after photos
View Before and Afters

Average Rhinoplasty Cost: $5,975

Learn about Rhinoplasty

5,047 people and 803 doctors are talking about Rhinoplasty

Get Free Email Updates

Insurance Coverage for Fixing Broken Nose?

asked 2 years ago by brooklynn72 in spring
Latest answer by John Diaz, MD
Question viewed 3,865 times
Tags: nose, broken nose

I got hit in the nose, and I'm wondering about how I can get it fixed. I don't want to say i have a deviated septum because I don't. I can breathe perfectly fine. It's crooked and ruins my self-esteem. Is there a way to get this fixed off of my insurance? I should be having medicare/medicaid soon.

Will I need to have a nasty crooked scar, or a scar in general, on the tip of my nose even though it isnt a whole nose fix? This was about a year and 1/2 ago. I know it's been long, but I have parents that don't find it very important as much as I do. What do I do to get it back to the way it was? Thanks.

15 answers to Insurance Coverage for Fixing Broken Nose?

+1

Insurance paying for broken nose

It is unlikely that an insurance company will pay for the surgery. Usually, insurance companies will ask for the following when someone submits a claim for a broken nose: 1. Emergency room report at the time of injury 2. CT scan which shows broken bones. 3. A report from a qualified doctor saying that the injury is causing some kind of breathing difficulty. It is unlikely you can have insurance pay unless you have this information.
John Diaz, MD

Beverly Hills Plastic Surgeon
+1

Insurance covers what is medically necessary

Your insurance will not pay for just fixing a broken nose that has been broken a long time ago unless it is causing a breathing problem. There is no medical necessity to fix this other than any cosmetic purposes. This is a cosmetic rhinoplasty, and insurance will not pay for this type of straightening of the nasal bones.
William Portuese, MD

Seattle Facial Plastic Surgeon

www.seattlefacial.com

+1

Insurance coverage for rhinoplasty

Hi, Thank you for your question. This is a tough situation. There are several things goin on. It seems as though this is more of a cosmetic procedure which insurance does not cover. Plastic surgery procedures have to be determined medically necessary in order for insurance companies to cover the procedures. Even then, some insurances, especially Medicare/Medicaid, do not cover them fully. It does not seem like this is medically necessary in your case, especially since it has been over a... more
Sam Speron, MD

Chicago Plastic Surgeon
+1

Insurance to pay for nose surgery

Insurance is a contract between you and an insurance company. Your Doctor has nothing to do with the process and will expect to be paid by you. Surgeons fees vary depending on the level of expertise, so you may find variation if you seek more than one consultation. This is one are in life where it pays to pay retail. Evaluate the surgeon, and their credentials as well as the years of experience. If you choose to submit the bill for services to a third party, that is your own choice and I... more
Darrick E. Antell, MD

Manhattan Plastic Surgeon
+1

Rhinoplasty for broken nose

Fixing a broken nose is routinely done and is usually covered by the insurance company. However, in order for this to occur, you may need a report from the emergency room that you visited after getting the broken nose along with a CT scan demonstrating the fracture. Otherwise, it may be difficult to convince the insurance company that it's not cosmetic. Good luck!
Jeffrey E. Schreiber, MD

Baltimore Plastic Surgeon
+1

Insurance coverage for fixing broken nose?

Hello, Your situation is not unique and you have a LOT of good answers to your question from other doctors. They parallel my opinions. If you have pictures of how you looked before the injury this can help your case. As I see it, your real outlet is to go to a teaching Hospital as recommended by the other responders unless you are going to pay for the procedure.
Michael Kulick, MD

San Francisco Plastic Surgeon
+1

Need a physical examinaiton

You will require a physical examination to determine the extent of your nasal injury.  At this time a plastic surgeon can determine if this is a reconstructive procedure or cosmetic procedure. 
Jeffrey Zwiren, MD

Atlanta Plastic Surgeon
+1

Rhinoplasty insurance coverage

The insurance company may only pay to re-align your bones. If you desire cosmetic improvement of your nose, then you will have to pay out-of-pocket.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Sounds like it is cosmetic at this time

Insurance will usually pay for an acutely fractured nose to be repaired. This really means that they will pay to have the bones placed back to the original configuration. They will not pay for cosmetic rhinoplasty. Deviated septum form my point of view is a misnomer. Nobbody has a perfectly straight septum. The deviated part is only important if it compromises nose function, from the insurance point of view. sek
Scott E. Kasden, MD

Dallas Plastic Surgeon
+1

Try a teaching hospital.

 Teaching hospitals probably offer your best option. The resident surgeons are supervised by a teaching plastic surgeon. The outcome is quite satisfactory in most cases.
Toby Mayer, MD

Beverly Hills Facial Plastic Surgeon
+1

Good Luck

It will be difficult if not impossible to get  a private plastic surgeon to do your nose for insurance. You might want to check out local hospitals that have Plastic Surgery residency progams. You might find that your insurance will pay for the resident to do the surgery.
William B. Rosenblatt, MD

New York Plastic Surgeon
+1

Insurance for Rhinoplasty

Dear Brooklyn Whether or not insurance pays for your rhinoplasty may very well depend on your insurance plan. Many plastic surgeons will write a letter of pre-authorization to get the surgery approved but this doesn't guarantee payment. Most insurance companies require a functional impairment like a breathing problem (or a deviated septum) to cover the surgery, and even then only the septal portion would be covered. In all likelihood you will need to pay for this out of pocket. If by... more
Steven Schuster, MD

Boca Raton Plastic Surgeon

www.schusterplasticsurgery.com

+1

Insurance coverage for a nose job with nasal fracture

With most insurance companies, it is possible to compose a letter to determine if they will cover the cost of surgery prior to performing the actual procedure. Unfortunately this is not possible, at least not in the state of Illinois. Therefore, you will have to find a surgeon that is willing to take a chance and bill afterwards to see if it is a covered procedure. Not many surgeons are willing to take this chance. However, you can call around and ask some questions. Medicare may cover a... more
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

Insurance coverage for fixing broken nose

Dear Brooklyn, In my opinion you are going to have a very hard time getting Medicare/Medicaid to pay for your surgery. A nose surgeon can look into your nose and determine if the deviation and other factors impede breathing. But - regardless of his/her opinion it will be up to Medicare/Medicaid to approve such surgery and later on to pay for it. You may want to look into the Medicare ABN (Advanced Beneficiary Notice) in which we are told to have our patients sign a Government mandated legal... more
Peter A. Aldea, MD

Memphis Plastic Surgeon
+1

Fixing broken nose mostly covered by the insurance companies

Repair of nasal fractures and deviated septum are services covered by the most inssurance companies. The incision needed for these surgeries are usually intra-nasal or a very small external incision that is easily hidden.
Hisham Seify, MD, PhD

Los Angeles Plastic Surgeon

Ask a question