What should I do about an old broken nose? Could someone please help me and if its possible to get it fix through my insurance?
Doctor Answers 6
repair of an old broken nose
Medical insurance will only pay for a function component, once medical necessity has been documented. A crooked nose is not medical necessity. Be prepared to pay for a portion of the surgery yourself.
It sounds like you may have internal deviation of the septum or other issues as well. If you are just looking to have to nasal fracture and breathing improved, then insurance will usually cover it. If you are looking for more significant change to the shape of the nose, that would be considered a cosmetic procedure and an out of pocket expense. Be sure to see a surgeon that specializes not only in rhinoplasty, but also the internal part of the nose.
Insurance coverage for old fracture
Most insurance will cover for functional airway problems.
However you may first have to do a song and dance. The insurance company may want you to see a doctor on their panel, for an opinion.
Further, what will be covered, aside from breathing problems, is variable. The amount allotted is also variable depending your coverage and insurance company.
If your surgeon is not a participating provider with your insurance company, they may pay only a pittance.
So, there is no way for us to accurately determine what, if any, benefits you may get.
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Thank you for your question.
I would recommend scheduling a consultation with a board certified plastic surgeon who specializes in nasal surgery to have a physical examination done and see what needs fixed. Anything internal should be covered by your insurance. The doctor’s office will call your insurance for a precertification to see if it will cover your procedure. If there is anything external that you do not like such as a hump or crooked appearance, this will most likely have to be paid for out of pocket. I hope this helps. Best of luck!
James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science
Hello and thank you for your question. Based on your
description, you are likely a good candidate for osteotomies, septoplasty, and spreader grafts. This can improve both the straightness of your nose and your breathing. Insurance usually covers this. The
most important aspect is to find a surgeon you are comfortable with. I
recommend that you seek consultation with a qualified board-certified plastic
surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon
Insurance will likely only cover the functional problem.. breathing issues associated with the fracture. Cosmetic improvement would have to be paid out of pocket.
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.