What should I do to convince my insurance to cover the septoplasty? (Photos)

Question

I've recently fell and broke my nose and have trouble breathing from my nose .last December i was out of the country and when I asked a doctor there he recomended for me to wait 9 months so the swelling and bruises of my nose can go away so you could get a septoplasty and a rhinoplasty so I could slim the bridges of my nose but my insurance wouldn't agree with the septoplasty even after telling them about my breathing problems. What should I do to convince my insurance to cover the septoplasty .

Matthew Bridges, MD, FACS · Answer

This is a tough issue that we deal with all the time.   You  will  have to appeal the decision and  hopefully have a surgeon within the insurance company with some knowledge of your issuea review your case.   The initial reviewer of your case in the insurance company likely had no idea about septoplasty and  rhinoplasty.

William Portuese, MD · Answer

First of all, it's important to look at your insurance booklet which will explain all of the inclusions and exclusions related to YOUR  medical insurance. It's also important for your physician to document medical necessity at the time of the examination and consultation in order to bill a septoplasty to medical insurance. It's also important to try and fail medical management prior to electing to undergo surgical intervention. Expect to pay for cosmetic rhinoplasty component yourself. Both a septoplasty and rhinoplasty are 2 completely separate procedures, however they both can be performed at the same time under the same anesthetic with the same recovery period.

Richard W. Fleming, MD (retired) · Answer

It is very unusual that a medical insurance policy does not cover the cost of a septoplasty to improve nasal function up to the limits of coverage for that particular operation especially when the patient has a history of previous documented trauma. Your surgeon can document the physical findings and justify the need for surgery.

What should I do to convince my insurance to cover the septoplasty? (Photos)

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What should I do to convince my insurance to cover the septoplasty? (Photos)

Answers (3)

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Our mission is to create a world where every investment in modern beauty is Worth It.