Septoplasty: Q&A
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Insurance Coverage for Septoplasty
I'm 17, and my nose was broken when I got hit in the face several times during childhood. It resulted in deviation of septum, fractured nose, and breathing problems. I have Americhoice by United Healthcare Insurance without out of network benefits. Rhinoplasty wouldn't be covered, but what about the Septoplasty? Does anyone know a doctor who could perform both Rhinoplasty and have the Septoplasty covered? In line with this, would it be a good idea to have two surgeons perform Rhinoplasty and Septoplasty (covered) separately, or just one ENT surgeon? Some mentioned it would be affordable.
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12 Doctor Answers |
Asked by
Loveceleb2
in new york
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Insurance Coverage for Septoplasty
As you suggest, Americhoice will most likely cover the septoplasty but not the rhinoplasty if it is deemed to be for cosmetic purposes. The same surgeon can perform a covered procedure and noncovered procedure at the same time without risking coverage. Consult your plans to ensure that you receive proper documentation from both the surgeon and any supporting physicians.
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Americhoice coverage for septoplasty
You are correct that, while septoplasty be covered by insurance, the insurance company will not pay for rhinoplasty. Americhoice is a Medicaid derivative run by United Healthcare. It operates by different rules than other United products. You should consult the United web site, which is one of the better ones in the industry and to read the requirements for coverage of the septoplasty. You do not need two surgeons. Both ENT and plastic surgeons are trained to perform this operation. I...
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Septoplasty and Rhinoplasty and billing Insurance
The Septoplasty portion of the procedure should be covered by your insurance as this is for the functional portion of the procedure. The cosmetic portion the rhinoplasty is typically not a covered procedure. Most surgeons do these in conjunction with each other at the same time when requested by the patient. You want to go to a surgeon that is skilled in this procedure and that is not always one that is in your preferred provider plan. I would suggest consulting with several surgeons,...
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No Out of Network Benefits
You need to contact your insurance carrier. They will give you the names of "in network" surgeons that will cover your surgery. If your nose was broken while you were under this same insurance, the cosmetic portion might be covered as it was caused by trauma, unless it has to be corrected within a certain time frame. If you have different insurance from when the injury happened, you need to find out if you have a "pre-existing" clause. Again, contact your...
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San Francisco Plastic Surgeon
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Nasal surgery and insurance coverage
Health insurance should cover both Septoplasty and rhinoplasty in your case, as the deformity was caused by trauma. Having said that, unfortunately many insurance companies try to get out of paying legitimate claims, and having a surgeon that would also be a good advocate on your behalf with the insurance company would help.
Typically a skilled surgeon should be able to properly execute both rhinoplasty and Septoplasty at the same time. Make sure you interview 2-3...
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One surgeon - both covered
While every insurance policy is different, most will cover septoplasty without much of a fuss. Some will require advance notification and precertification. Some insurance will also cover FUNCTIONAL rhinoplasty. Rhinoplasty simply refers to reshaping of th nose. In some cases, the reshaping must be done to improve the ability to breath through the nose. In other cases, it is purely cosmetic. For functional rhinoplasty surgery, some insurance will provide reimbursement. Again, it is best to...
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Most medical insurance companies cover septoplasty, NOT rhinoplasty
Yes, most medical insurance companies cover payment for a septoplasty. Rhinoplasty is paid for by the individual since it is cosmetic surgery. Typical costs for a rhinoplasty range between $5,000 and $7,000, depending upon how complex it is. It is a good idea to have one surgeon perform both surgeries, since all plastic surgeons can perform both functional and cosmetic components. Check with your United Healthcare insurance locally to determine your benefits.
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Insurance will only pay for the septoplasty
A good rhinoplasty surgeon, whether they are an ENT or Plastic Surgeon, will be more than capable enough to do both a septoplasty and a cosmetic rhinoplasty.
However, insurance will only pay for the septoplasty portion of the operation.
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Cost of Septoplasty and Rhinoplasty
Septoplasty is a surgery performed to correct a deviated (or crooked) septum. The septum is the piece of cartilage that separates one side of the nose from the other. Normally, the septum is straight. When it is crooked, it is termed a deviated septum. A deviated septum can block the nasal passage and contribute to symptoms of nasal obstruction.
A septoplasty does not change the shape of the nose and is therefore considered a functional procedure as opposed to a cosmetic procedure. As such,...
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Insurance Coverage for Septoplasty
You are approaching it the wrong way.
Your first question should be, 'What do I want?' Better breathing, better looking nose, or both.
Septoplasty is easy and any ENT surgeon can do it for you. You should be able to find someone in your network.
Rhinoplasty is a whole different ball game. You want it done once and done right. Trying to save some money you might end up with a poor result. If money is an issue you should only get septoplasty and save money for a rhinoplasty down the road.
I...
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A good rhinoplasty surgeon should be able to do both.
Whether you go to an ENT of plastic or facial plastic surgeon, he should be able to do both operations at the same time. Insurance will only pay for the septoplasty.
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Insurance coverage for septoplasty
Most plastic surgeons are capable of performing septoplasty, but many prefer getting an ENT colleague involved. Sometimes, from a practical standpoint, it's easier to get insurance approval for the septoplasty if pre-authorization comes from another surgeon who is distinctly separate from the cosmetic procedure. Still, many plastic surgeons choose to do their own septoplasties; it's very dependent on individual preference.
If you have a history of breathing problems, and a surgeon...
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