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Crooked Nose: Covered by Insurance? (photo)

I have a crooked nose. I think I have a deviated septum because I find it hard to breathe,mostly at night. I also have a messed up sense of smell. I don't know if that has anything to do with the crookedness. But I find it hard to smell things. I told my doctor and she checked my nose but said she doesn't think it is serious enough for surgery. I hate how my nose looks though. It is crooked and the tip is boulbous, I also have a bump. Is it possible to have the insurance cover my surgery?

Doctor Answers (13)

Rhinoplasty may be accompanied by correction of a deviated septum.

+2

Hi J18;

Your crooked nose looks like it was due to an accident.  If you cannot breathe, then it does, indeed, make sense that you probably have an internally deviated septum, which is probably also the cause of your external crookedness.  Certainly, your nose looks like it.  The sense of smell can also be affected by poor breathing. 

You said that you, "told your doctor…, but she does not think it is serious enough for surgery."  Was the doctor a specialist in nasal surgery?  Or was this your personal doctor?  If the doctor was a family practitioner internist, I think the wise thing to do would be to realize that she may not be an expert, and that you need to consult with a specialist who is.  That specialist would be one who does considerable nasal surgery - both cosmetic and functional - in their practice.  Look for a board certified head and neck (ear, nose, & throat) specialist, or a board certified plastic surgeon specialist. 

With respect to insurance covering your surgery, understand that insurance covers surgery to improve function, such as to improve your breathing or correct allergies and sinus problems.  It does not pay for purely cosmetic changes like reducing the bulbosity of your tip.  Frankly, it pays to combine the procedures because, at least, you will have the benefit of the insurance coverage for a portion of the surgery.

Be sure to have your insurance agent or employer check with your insurer to find out the benefits for the correction of the deviated septum and any other surgery.  The cosmetic rhinoplasty  part will be your treat to yourself. 

Robert Kotler, MD, FACS
Facial Plastic Surgeon
Author, SECRETS OF A BEVERLY HILLS COSMETIC SURGEON
Author, THE ESSENTIAL COSMETIC SURGERY COMPANION


Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 57 reviews

Insurance Coverage to Fix Crooked Nose

+2

Your nasal surgeon will examine you and determine if surgery will improve your breathing. With that information you can request pre-op authorization from your insurance company.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Rhinoplasty

+2

Your posted photos look like you sustained a frontal blunt trauma to your nose. If that is the case and especially if it is documented in your medical records the entire surgery would be covered by insurance. In the absence of that insurance will only cover the part of surgery that restores your breathing.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

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Insurance coverage for crooked noses

+2

Insurance companies will generally cover surgery that is medically necessary.  Most insurance companies have written guidelines that you could search on the internet that states what criteria they use for this determination.  In general, surgery specifically aimed at relieving obstruction of the airways or to correct trauma (i.e. a nasal fracture) should be reimbursed.  However, they will not cover any portion (including anesthesia and any facility fees) that are considered cosmetic, or not medically necessary.

Tito Vasquez, MD, FACS
Southport Plastic Surgeon
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Crooked nose: covered by insurance?

+1
Hello! Thank you for your question! Surgical procedures for aesthetic purposes, to improve appearance, are not covered by insurance. Typically, these as well as complications resulting from such procedures are the responsibility of the patient. Procedures that are meant to correct functional issues and those which cause health-related issues should be covered by your insurance as a medical necessity, with proper examination and documentation. Some insurance plans have exclusion criteria for certain procedures. Also, it is an obligation of the surgeon not to attempt to authorize purely cosmetic procedures through insurance.  Insurance may cover the septoplasty, but not the rhinoplasty portion.

Discuss your issues and complaints with a board-certified plastic surgeon to discuss these as well as to examine and assist you in deciding which procedure(s) will be the best for you. A discussion of the advantages and disadvantages will take place along with the risks and benefits. Insurance companies will vary on coverage and is always reasonable to discuss your issues with your surgeon and primary care. It would behoove you to get as much information as possible and even call your insurance yourself. Certainly, pay in advance prior to your surgical procedure and options such as financing are available if you qualify. Hope that this helps! Best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
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Insurance and Rhinoplasty

+1

                  It’s not unreasonable to seek prior authorization from insurance carriers for both rhinoplasty and septoplasty simultaneously. Post traumatic deformities of the nose and deviated septum’s can both be caused by trauma and both problems may therefore be covered by insurance.

                  It’s not unusual for septoplasty to be covered by insurance, especially when nasal airway obstruction is present. Under these circumstances, this represents a functional problem. Rarely insurance covers reconstructive rhinoplasty as a restorative procedure.

                  In some cases, insurance carriers approve septoplasty, while denying benefits for rhinoplasty. In this situation nothing is lost by running the rhinoplasty through insurance. For this reason, there’s no reason, not to seek prior authorization for both procedures if there’s any question about insurance coverage.

                  Following rhinoplasty, patients are eager to resume their normal exercise routine. Unfortunately, any maneuver that elevates blood pressure in the immediate post-operative period can result in bleeding. For this reason, strenuous activities should be avoided for six to eight weeks following rhinoplasty and septoplasty. 

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
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When insurance covers surgery to fix crooked nose

+1

A crooked nose is only paid for by insurance when it is due to a nasal fracture.  Breathing related surgery is also a covered medical condition.  Any cosmetic surgery must be paid for by the patient, it is not billed to insurance.  A deviated septum can cause nasal obstruction and a decreased sense of smell due to the lack of airflow up into the highest portion of the nose where the sense of smell organ exists.  It is possible to perform both functional and cosmetic surgery at the same time, but the patients are required to pay for the cosmetic portion separately.

William Portuese, MD
Seattle Facial Plastic Surgeon
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Insurance coverage for crooked nose surgery

+1

You need to have your nose fully examined by a specialist with a thorough understanding of nasal obstruction correction to see what can be done to help your breathing and smell.

Insurance can cover functional surgery to help with chronic congestion. This would include septoplasty, turbinate reduction, alar batten grafts and/or spreader grafts. 

Insurance doesn't cover surgery to correct tip bulbosity or a bump, but this can be done at the same time as functional surgery if you want.

Thomas A. Lamperti, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

Crooked nose

+1

You are certaqinly a good candidate for a rhinoplasty based in your photos.  What needs to be done to improve your breathing cna only be assessed by a physical exam.  As far as whether insurance would cover all or part of the cost depends on a number of issues.  If the crookedness is the result of an injury, insurance would bmore likely to cover the cost.  If not, they may cover only the part involving your breathing, but not any  cosmetic alterations.  You should check with your insurnace carrier to determine their policy, then consult with a surgeon who can assess your situation and obtain insurance preauthorization.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 11 reviews

Insurance companies and nasal surgery - what may be covered

+1

At best, insurance companies will cover surgery related to the breathing issues regarding your nose such as the septum. They will not cover anything that constitutes cosmetic surgery such as fixing your bulbous tip.

You should go to a board certified plastic surgeon who could assess your situation and them make the appropriate recommendations.

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 20 reviews

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.