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Insurance Coverage for Functional Rhinoplasty

asked 3 years ago by szaman in Florida
Latest answer by William Portuese, MD
Question viewed 554 times
Tags: function, insurance

Last December, my daughter had a Rhinoplasty to fix collasped nose (nasal airway). She was born with cleft lip. Insurance company paid her Anesthesiologist but they are refusing to pay surgeon and hospital bill totaling $9600. Cigna is saying my employer medical plan does not cover Rhinoplasty. Can anyone give me any suggestion how to make Cigna pay for these bills? Thanks.

3 answers to Insurance Coverage for Functional Rhinoplasty

+2

I would talk to a supervisor.

 This is a functional problem and in my opinion should be treated as such. If you still don't get resolution you can call the insurance commission in your state.  You can contact the television consumer affairs reporter in your area.
+1

Talk to your state insurance commissioner

Insurance companies typically do not cover any cosmetic surgery such as a rhinoplasty. Check with your insurance plan and look for coverage under congenital deformities such as a cleft lip nose. One suggestion would be to consider talking to your state insurance commissioner to help guide through the process of assist in payment for a congenital deformity. Whether or not they will pay for it is spelled out in your insurance booklet.
+1

Insurance comission

I agree completely. You should skip dealing with Cigna directly. This will not be fruitful. Proceed directly to the insurance comssion. They can be very helpful and have aided my patients (here in WI) more than once.

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