How To Find An Insurance Company That Will Cover My Rhinoplasty For Injury Related Reasons? (photo)

A few months ago I broke my nose playing basketball. Since that time I have had trouble breathing through my nose. There is no doubt that I have a deviated septum and crooked nose. It looks like it is going to cost around $10,000 to get this fixed. How can I find insurance that will cover part of this and would this case be considered pre existing? I don't have a problem covering part of this or at least the cosmetic portion. From the pictures what kind of surgery does it look like I need?

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4 Doctor Answers | Asked by realself619 in CA

Doctor Answers (4)
Community Comments (1)

Rhinoplasty for Broken Nose

Hello, Thank you for including photographs with your question. It makes having a meaningful discussion a little more realistic. I agree with Dr. Hilinski about finding a good PPO plan that allows you to choose your physician instead of being assigned one through an HMO. You will have to ask the insurer if they consider this trauma a preexisting condition and how that would impact your copay and deductible. In San Diego many physicians... more

Rhinoplasty and insurance

I'm not sure your approach will be successful. The problem is that when you get health insurance, there will likely be a waiting period before they will cover elective surgery. Most insurance carriers may cover this type of surgery, but they are likely only to pay for the septoplasty part, and not any part they consider cosmetic. You see, the insurance companies are pretty smart, and believe me, they will make sure in some way, shape, or form that they don't come up... more

How To Find An Insurance Company That Will Cover My Rhinoplasty For Injury Related Reasons?

Most health insurance companies have a prior conditions clause that might dis allow you coverage. In some cases there is a 6 to 12 month delay clause. It is your responsibility to understand all these clauses/restrictions in a health policy before signing on.

Septorhinoplasty and Medical Insurance Coverage

Jeff, this is fairly common to have insurance coverage for nose surgery following a traumatic injury. I would suggest you get a solid PPO plan that allows you to choose your surgeon. An HMO plan will limit you to whatever doctors are on their panel, which is usually a narrow choice. I have provided a link below that will give you more information regarding use of health insurance to have this type of surgery performed.

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Comments (1)

realself619 20 Nov 2012

Wouldn't this situation be considered functional and due from trauma, therefore having it covered by insurance? Is anyone familiar with PCIP insurance or had any patients use it? From what I understand and agents have told me, this procedure would be covered in my situation. I will be out of pocked around $3,000 but the rest will be covered.

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