I HATE the hump in my nose, but I cant afford to get it shaved down. How can I get my doctor and insurance to get it covered?
Is It Possible to Get Insurance to Cover Rhinoplasty for Just the Hump in my Nose?
Doctor Answers 16
Insurance and nasal surgery
I agree with the other members of the panel. We will have patients who want surgery start a piggy bank account to cover the costs. Like anything in life, it is a matter of choices and priorities. Good financial prudence and saving for an important goal is one of the most satisfying things in life. If you want it bad enough and it is appropriate to proceed, than go for it. See a board certified Plastic Surgeon or fellowship trained Facial Plastic Surgeon for an opinion of the type of procedure needed and the risks etc.It is simply not ethical to do cosmetic procedures for non insured reasons.
Hump removal is part of a rhinoplasty. The hump does not cause nasal obstruction and therefore is not a medically necessary procedure. A broken nose with associated deviated septum can be submitted to insurance. Make sure you look at the exclusions in your medical insurance contract to understand what is and is not a covered benefit.
Insurance Will Only Pay For Parts Of A Rhinoplasty That Would Improve Breathing
It is true that some aspects of a rhinoplasty can be covered by insurance. Rhinoplasty is performed for both aesthetic and functional reasons. The most common reason to have a rhinoplasty for a functional reason is for patients that cannot breath well through their nose after multiple treatments including medications, breath right strips, and/or allergy shots.
A rhinoplasty that is completed only to improve the appearance of the nose is not covered by insurance. In situations when both functional and aesthetic indications for a rhinoplasty, insurance will cover part of the case to improve breathing. I would be wary of a doctor that would tell you that insurance would cover the surgery to only change the appearance of the nose.
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Insurance does not pay for cosmetic surgery or cosmetic nose jobs
You cannot expect most insurances today to pay for cosmetic surgery or cosmetic nose jobs. In the past they often did. And some international or military or diplomatic insurances still may.
But most of the time when you hear of someone who had a nose job through insurance it was either due to trauma or breathing issues and only specific parts of it are paid for by insurance. A dorsal hump is almost always not paid for by insurance.
Now, some doctors will commit insurance fraud and bill cpt codes to insurance to make it look like they did something else like a septoplasty or sinus surgery and Iv even seen doctors who billed skin lesion excisions and trauma codes to get paid by insurance for a cosmetic nose job. But busy and highly sought after plastic or facial plastic surgeons do not take such risks or play such dangerous games with insurance and Id suggest you stay away from the ones who do
Insurance Coverage of Hump Reduction
Insurance will not cover a cosmetic procedure such as dorsal hump reduction. Kenneth Hughes, MD Los Angeles, CA
Will insurance cover the removal of a nasal hump?
Unfortunately, insurance companies will only cover the functional aspect of your surgery. On occasion, some cosmetic work may be covered if it contributes to improving your breathing. For example, if your breathing issue is partially due to nostrils that are pinched, they may cover part of the cost. There are financing companies available that help make surgery more affordable for the patient. I hope this helps, and I wish you the best of luck.
Hump removal and insurance
Insurance may cover work on the nose related to documented trauma and issues with airway obstructions. They will not cover routine hump removal for cosmetic reasons.
Rhinoplasty, nose surgery and insurance coverage for hump removal
Insurance companies usually do not cover surgeries, to improve the appearance and consider these procedures as cosmetic. However, if the hump or other deformities are as a result of traumatic injuries or compromises the function of the nose , they may consider covering the cost of surgery. In those circumstances it is a good idea to obtain a prior authorization, which could be requested by the practicing surgeon.
Is It Possible to Get Insurance to Cover Nose Surgery
Insurance is designed to help with health care expenses. It does not cover cosmetic surgery and rarely will even cover complications of cosmetic surgery. If the nasal deformity is the result of disease or trauma, you may have coverage.
Insurance will, unfortunately, not cover nasal surgery to improve the appearance of your nose
Insurance will, unfortunately, not cover nasal surgery to improve the appearance of your nose. Insurance will cover, in most cases, surgical procedures that improve your nasal breathing. However, shaving down a bump on the bridge will not create a functional improvement. It is a strictly cosmetic maneuver. Therefore, your insurance will not consider that a covered benefit. I hope this information is helpful.
Stephen Weber MD, FACS
Weber Facial Plastic Surgery
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.