Will Insurance Cover my Septoplasty And/or Rhinoplasty? I've Developed Sleep Apnea.

asked 7 months ago by David5859
Latest answer by Robert Kotler, MD
Question viewed 138 times
Tags: insurance, sleep apnea, trauma

I sustained a trauma to my nose in 2005. My nose was pushed to the side of my face. The doctor cracked it back into place, but it is still misaligned and has a dent on the side. I had insurance then and still have insurance, but with a different carrier. I was diagnosed with moderate sleep apnea in 2009 and sleep with a cpap machine on high pressure. I was wondering if insurance is likely to cover septoplasty and/or rhinoplasty? My current insurance is crap and excludes sleep apnea treatment.

5 answers to Will Insurance Cover my Septoplasty And/or Rhinoplasty? I've Developed Sleep Apnea.

Septoplasty and functional rhinoplasty should be covered by your insurance if you had an accident.

Dear David5859: The trauma that you had to your nose in 2005 appears to have changed the shape of your nose. If the accident also caused the change in your breathing, then certainly your insurance should participate in payment for the reconstructive surgery. There is a difference between that and cosmetic surgery, which is improving what Nature gave you. Reconstructive surgery is trying to restore your nose to reasonable form and function after an accident. The fact... more

Robert Kotler, MD
Beverly Hills Facial Plastic Surgeon

Septo/rhinoplasty for Treatment of Nasal Trauma & Sleep Apnea

Insurance companies frequently pay for surgery to treat a broken nose and nasal surgery in patients with sleep apnea. You surgeon's office can help you get pro-operative authorization. However, it is extremely difficult to determine how much they will pay.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

Nasal surgery and sleep apnea

If you have a significant deviated septum, then insurance should cover the surgery. "Cover" could mean they pay for 80% of the cost after you have paid your $2000 deductible for the year plus the 20% copay. If your external nose is severely deviated from injury it might also be covered; that is much harder to predict. An experieced rhinoplasty surgeon should have staff that can help you get a better idea about these out of pocket costs for insured patients like yourself. more

Edmund Fisher, MD
Los Angeles Facial Plastic Surgeon

Rhinoplasty, Sleep apnea and Insurance

I wish I ccould give youo the simple answer, but it depends on your insurance carrier. Many will cover the allowed expense of a septorhinoplasty if it is the result of trauma. Others will say the external nasal wwork is cosmetic and will only cover the septum. Many doctors will not accept what insurance reimburses as the full cost. I would see several plastic surgeons in consultation. Once you have decided on one of them a pre-authorization can be obtained ... more

Steven Schuster, MD
Boca Raton Plastic Surgeon

Rhinoplasty and sleep apnea

A traumatic injury that caused a deviated fractured septum may very well be covered by insurance, but sleep apnea is usually unrelated to septal deviations.

Steven Wallach, MD
Manhattan Plastic Surgeon

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