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Will a Septo-Rhinoplasty Be Covered by Insurance?

I have a deviated Septum, and after consulting an ENT found out that Septoplasty is the best option for me. However, I also have a bump on my nose that I would like to remove and I was wondering if my insurance would cover the procedure if my surgeon shaved off the bump while he's fixing my deviated septum. If I write down on the insurance information that the PRIMARY reason for the surgery is for medical reasons, would my surgeon be able to perform both procedures at once?

Doctor Answers (10)

Medical Insurance for Septorhinoplasty

+1

If you have a functional problem, such as breathing obstruction, your insurance will probably cover a portion of the charges for that aspect of the surgery. Medical insurance will not pay for the cosmetic work. Ask your surgeon to help you approximate your out of pocket expenses. Do the septum and the cosmetic surgery at the same time because you'll have only one operation and the final cost will be less.


Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 reviews

Does insurance cover plastic surgery or rhinoplasty for deviated septum?

+1

Hi mrsfredweasley in California,

The majority of cosmetic surgery is elective, so insurance plans don't usually cover it. However, there are exceptions. Remember, plastic surgery covers a broad area of medicine which includes both reconstructive procedures and cosmetic procedures. If your procedure is medically indicated, some portion of the cost may be covered.

Septoplasty, or surgery to improve a deviated septum, is normally covered by insurance plans. However, cosmetic changes to the external nose, such as reducing a bump or refining the nasal tip is not covered. Only after a comprehensive evaluation by a rhinoplasty surgeon, can he/she help determine appropriate options for you. Best of luck.

Dr. C

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 46 reviews

Rhinoplasty and Medical Insurance

+1

Septal surgery for an obstructive nasal issue is usually covered medical insurance.  The hump on the bridge of your nose usually does not cause any functional problems with your nose.  The fact is that the hump is unattractive therefore it is a cosmetic procedure.  These two procedures are commonly performed together.  

Dr. ES

Earl Stephenson, Jr., MD, DDS
Atlanta Plastic Surgeon
5.0 out of 5 stars 8 reviews

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Insurance coverage of septo-rhinoplasty

+1

Septoplasty surgery to correct a deviated septum may be covered by insurance if it causes respiratory difficulties or other medical problems. In addition, you need to check with your insurance company regarding specific policy since surgery for asymptomatic septal deviation may be denied. Hump removal for cosmetic reasons will most likely be denied as well. 

Olivia Hutchinson, MD
New York Plastic Surgeon
5.0 out of 5 stars 5 reviews

Is Rhinoplasty Covered By Insurance?

+1

Cosmetic changes to the nose are never covered by insurance.  Problems which are related to breathing such as a deviated septum may be covered by insurance.  In addition, problems which are related to trauma, such as a crooked nose after a hit to the nose may also be covered by insurance.  

There are many benefits to having surgery which improves breathing and functionality of the nose coupled with cosmetic changes to the nose at the same time:

  • Patient can have one operation to correct two different issues and therefore one anesthetic and one recovery period
  • Overall cost is typically much lower to combine procedures than to perform them at separate times
  • Cartilage which has been removed during the functional portion of the case can be used for the cosmetic case.  Most surgeons "throw away" the cartilage during a septoplasty (I do not).  If this cartilage is removed and thrown away, and a planned separate subsequent procedure would be much more complex and may require either auricular (ear) grafting or costal (rib) grafting
  • There is some overlap between the cosmetic and functional portions.  For example, straightening a septum (which can be highly complex- see attached link to a paper I wrote on open septoplasty techniques) is often necessary in creating a straight nose from the frontal view.  Failure to address this issue can leave the nose worse off both cosmetically and functionally.

The nose is a highly complex structure and requires a surgeon of expertise in handling both functional and cosmetic issues.  If you do have a functional issue and are considering cosmetic changes as well, it is worth your time to make sure you decide one way or the other before your procedure.  Otherwise, if you seek cosmetic changes later after a standard septoplasty technique (more than 90% of surgeons use a submucous resection technique)  your rhinoplasty will be much more complex.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 65 reviews

SAlways Pays to Combine Breathing Surgery with Cosmetic Surgery

+1

Hello, Mrs. W.

Good thinking re combining the breathing surgery with the cosmetic surgery.

Insurance covers correction of the deviated septum if it is causing breathing problems. Check with your insurance agent or your companies HR department, regarding the specifics of your policy. Very important; assume nothing.

However, generally insurance covers the breathing operation. It will not pay for the bump removal which is a cosmetic issue. In your favor is that if you add the cosmetic procedure onto the surgical plan, the extra charge for the bump removal should be very reasonable.

Ask the doctor for an exact quote based on what information you and the office get from insurance company. There should be no guesswork.

 

Robert kotler, MD, FACS

Beverly Hills, CA

Robert Kotler, MD
Beverly Hills Facial Plastic Surgeon
4.5 out of 5 stars 52 reviews

Insurance doesn't cover cosmetic surgery

+1

Your insurance is likely to cover septoplasty, but not the bump removal.  Anything that is done to improve or change the appearance of your nose is considered elective and is not covered by insurance.  The patient would be financially responsible for the hump removed.

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

Septo-Rhinoplasty Be Covered by Insurance

+1

Only partially will there be insurance coverage because part of the operation is deemed cosmetic. So shall we say half is insurance and half is cosmetic or self pay. That is the general rule of thumb. Yes both can ber done by one surgeon at the same operation. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 61 reviews

Deviated septum

+1

A deviated septum may be covered by your insurance if you have symptoms related to the deviation. On the other hand the improvement of the nasal bump is cosmetics and will not be covered.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 reviews

Septorhinoplasty for a functional problem is covered by insurance.

+1

The removal of the bump and any tip work will not be covered unless it is in some way contributing to your breathing problem. Your surgeon can answer the question after examining your nose.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
5.0 out of 5 stars 14 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.