I've broken my nose several times, most recently 6 months ago. Last week I fell on some ice and since then its hard to breathe, i get severe headaches& developed sleep apnea. I saw an ENT Dr who said I may have fractured my nose, my septum was visually deviated in 3 places, and that i had some cartilage deformity. Surgery was suggested. Will this likely be fully covered by insurance? He hinted at me addressing my visual concerns..will that be included due 2 my injury? I can't afford plastic/surg
Broken Nose, Deviated Septum, Cartilege Deformity? (photo)
Doctor Answers 5
Broken Nose and Deviated Septum -- Covered by Insurance?
Yes, repair of a broken nose and deviated septum are generally covered by insurance. Each plan has its own requirements and restrictions, however, and deductibles or patient responsibilities vary widely. In cases like yours, I perform the functional or reconstructive portion of the surgery as an insurance case; if patients want to add on a cosmetic component (such as taking down a bump or making the tip smaller), this can be done for a reduced fee during the same procedure.
Broken nose and deviated septum
A fractured nose and deviated septum are usually covered as a medical necessity under a patient's medical insurance. A fractured nose and deviated septum must be documented with x-rays and preauthorization must be performed prior to undergoing surgery. Any cosmetic changes to the nose are not pay for by insurance company must and must be paid for by the patient
Deviated septums are usually covered by insurance, crooked noses not always
If you have documentation of nasal trauma and x-rays by a doctor and an emergency room visit, this can often be addressed and billed to insurance along with the deviated septum repair. However, if it is some irregularities that aren't dramatic or severe angulation of the nose, insurance companies are less often likely to cover the external portion of surgery.
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Broken Nose, Deviated Septum, Cartilege Deformity?
Most insurance companies will approve nasal surgery to improve your nasal breathing. However, none will cover portions of the procedure performed to change the way your nose looks. That will always involve some sort of additional charge for the cosmetic portion of the procedure. I hope this information is helpful.
Stephen Weber MD, FACS
Broken nose, deviated septum, cartilage deformity?
Hello, and sorry to hear about your accident. Depending on your insurance company, they will likely cover some or all of the functional portion of your surgery. Any cosmetic changes would be billed separately, and will not be covered by insurance. I hope this helps, and I wish you the best of luck.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.