Will Rhinoplasty Be Covered by Insurance if I Have a Deformed Nose? Resulting from an Old Injury.

(Nose Reduction,Fixing of Nasal) When I was around 7 years old I got into an accident which caused my nose to Be malformed and In my opinion to become larger than it should be . The doctors said to wait until you're 18 to have surgery . So my Question is since I'm now 18 will insurance Pay For the Nose Reduction and Fixing of Nasal ?

Doctor Answers (8)

Insurance Coverage for Nose Reconstruction

+2

If there is a distinct injury or trauma to the nose (as in your case) and it can be shown to have realistically affected the growth (or abnormal growth) of your nose, insurance is likely to cover it in my experience. I happen to do a fair amount of reconstructive nose surgery through insurance. There has to be solid documentation of your past history and it has to be explained that there is a direct link to why your nose structure is the way it is now. Meaning, it would likely have been different had you not broken your nose some time in the past. You are not alone. There are many patients who successfully get their nose reconstructed in this exact manner. Good luck.


San Diego Facial Plastic Surgeon
5.0 out of 5 stars 18 reviews

Insurance and rhinoplasty

+2

Insurance will often cover the cost for repair of internal nasal deformities and their effect on breathing.  They do not usually cover external nasal surgery for cosmetic reasons unless it is due to cancer or cleft lip/palate.  Good luck .  Donald R. Nunn MD  Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 5 reviews

Rhinoplasty and insurance

+2

Sometimes is the answer.  However, the areas that would be corrected would be mostly internal for breathing related purposes.  With that being said, if the operation is designed to improve breathing and a nasal pyramid fracture or deviation is creating part of the problem then you would expect that to be corrected as well and covered.  But you said the magic words by your concerns about being wider than it was.  It's not about what your nose looks like to the insurance companies.  It's about function.  The moment you start making cosmetic changes to the nose the insurers or medicare or medicaid etc...will instantly deny the claim.  And they do so by simply reading our operative notes.  So you have one of three choices:  1.  correct the breathing issues and possible old fracture with the expectation that your nose will likely be too wide and still not be ideal.  2.  Do the above and discuss with your surgeon what the cosmetic fees may be thus saving some money on the cost of the operation by treating it as a dual procedure.  or 3.  Some insurance companies are so bad about rotely denying claims that you may want to consider visiting with a Double Board Certified ENT/Facial plastic surgeon, treating the whole operation as a cosmetic one, paying out of pocket over time, but have every last bit of your nasal issues addressed to your satisfaction.

Shepherd G. Pryor, MD
Scottsdale Facial Plastic Surgeon
4.5 out of 5 stars 20 reviews

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Will Rhinoplasty Be Covered by Insurance if I Have a Deformed Nose? Resulting from an Old Injury.

+1

      Internal issues affecting breathing are usually covered.  External issues and cosmetic issues will not be covered.  Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.
Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 192 reviews

Will Rhinoplasty Be Covered by Insurance if I Have a Deformed Nose? Resulting from an Old Injury

+1

It depends on what cosmetic and functional issues you want to correct.

If you are concerned with breathing which is a functional issue then this should be covered.

If your nose is twisted or crooked and causing breathing issues, then this may also be covered because it is easy to imagine how a trauma to your nose could shift things and cause them to grow asymmetrically. Sometimes it takes a little extra work to get it approved but it often will be if it is to address breathing issues.

Justifying that trauma caused a nose to be bigger is a difficult argument to make because trauma is unlikely to make a nose bigger. It is therefore much more difficult to have reduction rhinoplasty (making the nose smaller) approved. 

Ultimately it really depends on your case, your surgeon and your insurance company.

 

Good luck

Stephen P. Smith, Jr., MD
Columbus Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Insurance and rhinoplasty

+1

insurance companies are not in the business of making noses look better, not usually at least.  often in order to get a carrier to cover a rhinoplasty one must make an argument in advance that the surgery is to improve function such as breathing that was made worse by the trauma.

Adam Bryce Weinfeld, MD
Austin Plastic Surgeon
5.0 out of 5 stars 32 reviews

Rhinoplasties not covered by insurance

+1

 To be covered by medical insurance, there must be a medical necessity such as air flow restriction. The airflow  restriction can come from a nasal fracture, a deviated septum, valve collapse  or vestibular stenosis, and turbinate hypertrophy. Insurance usually covers these medically related issues. A rhinoplasty is not covered under any medical insurance

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 55 reviews

Insurers may or may not cover a cosmetic nasal deformity secondary to trauma.

+1

I think it's a flip of the coin whether or not insurance will cover for aesthetic correction of an injury sustained to the nose many years ago. The place to start is at the plastic surgeon's office.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 8 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.