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Will Insurance Pay for my Rhinoplasty to Address Breathing Problems?

asked 1 year ago by anon
Latest answer by Jonathan Berman, MD
Question viewed 1,057 times
Tags: nose, breathing, broken nose, deviated septum

i broke my nose 4 yrs ago recently i have had problems breathing. the r.side of my nose has a bump on the side,also have a fairly large bump on the bridge.my mom got hers fixed in '82 and insurance paid for most of it because it was a deviated septum her doctor also corrected her nose for no extra cost. if a doctor believes i have a deviated septum will they cover the procedure?how do i go about getting something like this?would fixing the dev.sep. make my nose look different?anything else?

12 answers to Will Insurance Pay for my Rhinoplasty to Address Breathing Problems?

+1

Insurance for Septorhinoplasty

You have both  functional and cosmetic concerns. Depending on your policy, insurance frequently pays a portion of the charges to improve your breathing. It would help if you can document your previous nasal trauma because the insurance company may treat this as reduction of nasal fractures. Your surgeon's office can request pre-operative authorization to help you determine your personal responsibility
Richard W. Fleming, MD

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

+1

Insurance Dollars for Rhinoseptoplasty

It has been my experience that it behooves the surgeon to obtain pre-authorization for their surgery. The third party will usually pay for medically necessary surgery, provided apporpriate medical documentation to support the proposed surgery is available. If there is associated trauma to the nose, the third party will often pay for reduction of a nasal fracture more readily than pay for a rhinoplasty. Third parties typically deem rhinoplasty a cosmetic surgery.... more
Jonathan Berman, MD

Palm Beach Plastic Surgeon

www.drberman.com

+1

Will insurance cover rhinoplasty?

Question: Will insurance pay for my rhinoplasty to address breathing problems? Answer: If you truly have breathing problems caused by an anatomical obstruction of your airway and, if this can be proven to the insurance company, and, if the insurance company accepts the story, the insurance company may honor and may pay for a portion of the procedure. Basically, insurance companies are very skeptical. They understand that the majority of people desiring a rhinoplasty do so for... more
Sigmund L. Sattenspiel, MD

Freehold Facial Plastic Surgeon
+1

Insurance companies vary in their coverage for functional rhinoplasty

The best place to start in obtaining information about insurance coverage for rhinoplasty is to call your insurance company or do an internet search for their policy.  The next step would be to visit an experienced rhinoplasty surgeon for an evaluation for both your functional as well as cosmetic nasal issues.  A precertification is often necessary.  Insurance companies do not typically cover cosmetic nasal issues, and the surgeon may charge an additional fee for their... more
Kevin Ende, MD

Manhattan Facial Plastic Surgeon
+1

Certain Portions of Rhinoplasty Surgery May be Covered by Insurance

Rhinoplasty is not one operation, but rather many potential operations to improve the nose and nasal breathing. Rhinoplasty surgery to improve a congenital deformity, acquired nasal injury, or sinus problems may be covered by your insurance provider, as these are considered more reconstructive plastic surgery. Rhinoplasty to improve a hump or narrow nasal tip is less likely to be covered by insurance, as it is considered cosmetic surgery. Lastly, insurance providers and plans are... more
Houtan Chaboki, MD

Washington DC Facial Plastic Surgeon
+1

Insurance will cover a broken nose or an airway problem.

How much they will pay will depend on the insurance company. Good insurance pays better than poor insurance. You can call and ask how much they will cover.
Toby Mayer, MD

Beverly Hills Facial Plastic Surgeon
+1

Insurance payment of FUNCTIONAL Nose Surgery

Most Americans THINK that medical insurance pays/should pay for every medical diagnosis or treatment. That is NOT the case. Your PARTICULAR policy clearly spell out what specific diseases/disorders they will pay for and how much YOUR share of the payment will be. Rhinoplasty can be functional (to improve breathing) or Cosmetic (to improve appearance). While MOST (not all) insurance policies MAY pay for functional rhinoplasties, none will pay for cosmetic rhinoplasties. You need... more
Peter A. Aldea, MD

Memphis Plastic Surgeon
+1

Insurance coverage for rhinoplasty

Most insurance companies will cover the functional portion of a rhinoplasty. They typically will not cover any cosmetic surgery. It really depends on what your surgeon is willing to accept in payment for his services.
Robert M. Jensen, MD

Medford Plastic Surgeon
+1

Insurance for nose job

Depending on your carrier and plan, insurance should cover the functional portion of your nasal surgery such as correcting a deviated septum, nasal valve collaps, or reducing the size of the turbinates. Changes to the outside of the nose are typically not covered by insurance.
Etai Funk, MD

Houston Facial Plastic Surgeon

www.funkfacialplastics.com

+1

Yes, to help you breathe, but probably not to remove the hump

It is getting harder and harder to predict whether or not insurance will cover certain procedures. However, usually for breathing problems like a deviated septum or collapsed nasal valve, insurance will cover the surgery.  If you feel your nose has changed in appearance after the trauma 4 years ago, insurance may or may not cover that part of the surgery. It will help you plead your case if you have X-rays, doctor visits, ER visits, or any paper trail about your prior fracture.... more
Theda C. Kontis, MD

Baltimore Facial Plastic Surgeon

facialplasticsurgerymd.com

+1

Insurance coverage of rhinoplasty procedure

It is possible that insurance will cover a portion of the procedure. Find a surgeon and have them compose a letter to predetermination of benefits to your insurance carrier to help ascertain your level of coverage.
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

Rhinoplasty

If there are structural problems with the nose, causing the breathing difficulty, then insurance will cover all or some of the surgical cost.  A prior authorization can be obtained in advance. Dr T.
Mehryar (Ray) Taban, MD, FACS

Los Angeles Oculoplastic Surgeon

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