In the middle of January, I got hit in the nose during sports. It hurt REALLY BAD, bled just a little bit. I didnt think it was broken because ut wasnt crooked. It took almost a month for it to get to feeling normal again. Then, I got hit again. Not as bad the second time but definitely had to sit out. Once the season was over I went to my doctor and he said that I had broken it. Now I have a small dorsal hump on the top of my nose. Is there any way to get insurance to pay for this?
Any Way to Get Insurance to Pay for a Dorsal Hump Removal?
Doctor Answers 8
If a direct linkage can be drawn for the dorsal hump or breathing problems to the documented nasal trauma then insurance companies will generally cover the procedure depending on your plan coverage.
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Dorsal Hump after Nasal Trauma
If the dorsal hump or breathing problems are secondary to the documented nasal trauma most insurance companies will pay for treatment of these problems. Your surgeon's office can help you to clarify your coverage before surgery.
Insurance covered for Nasal Fracture
The answer is yes. However, every insurance plan is different, some require preauthorization with proof of fracture and some do not. The surgeon and check this for you.
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Insurance for rhinoplasty
If you had severe trauma that is well documented, it may be covered. This usually includes airway obstruction and proper evaluation through exam and CT studies.
Insurance coverage of dorsal hump removal
The insurance coverage usually extends to surgeries that correct functional nasal problems, such as nasal obstruction. Insurances also provide coverage for reconstructive surgery aimed at correction of nasal deformity due to prior trauma. However, the deformity needs to be fairly severe to qualify for reconstructive procedure, such as severe nasal deviation, saddle nasal deformity, etc. Correction of dorsal hump is really a gray area: from one hand it may indeed be traumatic in etiology, but from the other hand it is a pure cosmetic procedure. I would say, you need to be prepared to pay out of pocket for this, but get a few consultations and see for yourself what options you will be offered.
Insurance coverage for nasal surgery
If your surgeon can document that the hump is the result of the nasal trauma by submitting photographs, CT scans, and any other relevant documentation, some insurance companies will cover reconstructive rhinoplasty to address this post-traumatic condition. Other insurance companies have specific criteria that only cover functional repairs to improved a compromised nasal airway. It is worth having a board certified plastic surgeon evaluate you, submit the documentation, and see if you can get coverage for this repair.
All the best,
Insurance can cover nasal injury
Of course, insurance will cover repairs after any nasal injury. However, the key is clear documentation, cause and effect, and a predetermination from your insurance of your covered benefits.
Functional and cosmetic rhinoplasty - insurance pays for what ?
If your surgeon can document a functional issue (obstruction, airflow issues etc) with your nose which he/she believes is a result of your injury, then insurance would pay for that portion of the operation - the functional part. The dorsal hump may, or may not be related to the trauma that your received - but its a cosmetic issue. Expect to pay out of pocket for any cosmetic correction to your nose that does not also address a functional nasal problem.
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.