I frequently have migraines and sometimes find it difficult to breathe. Will Insurance Cover Rhinoplasty?

In general most insurance companies consider a rhinoplasty to be aesthetic in nature and typically do not afford coverage there. They may cover the inside part or septoplasty for breathing issues which could help with some of your other symptoms. It is often less expensive to do a rhinoplasty at the same time as there may be lower surgical costs involved depending upon your surgeon.

insurance + rhinoplasty = frustrastion.

insurance will generally cover procedures that improve severly abnormal breathing.  there may be some crossover with your headaches.  this includes septoplasty, turbinate reduction, correction of nasal vestibular stenosis.  it has been my experience that they are very unlikely to pay for "rhinoplasties."  the deep nasofrontal angle likely will be viewed as cosmetic by united and by reputable plastic surgeons.  with that said you may have anatomic issues such a deviated septum that may overlap with the cosmetic procedure and thus reduce the cost somewhat.  let me want you, the  savings are generally modest.  so dont be disappointed.

 

about migraines - with patients like you (especially with migraines behind the eyes) i get a ct scan.  often we see severely deviated spetum, large turbinates that touch the septum, and concha bullosa.  these are all often corrected with surgery and can really help.

Cosmetic rhinoplasty is not covered by any medical insurance. If you have failed medical therapy for nasal obstruction, your health plan may participate  in surgery for a deviated septum if it has been documented. Migraine headaches are also not improved with any nasal surgery.  Sinus headaches can be improved with functional endoscopic sinus surgery, but this will need to be documented on a CAT scan.

Insurance companies in general are approving less and less.  Usually with rhinoplasty if there is significnat nasal trauma and ariway breathing issues, then they may approve it. I doubt very much that it will be approved because you have migraines.

Medical insurance will typically only cover those parts of rhinoplasty related to functional problems such as nasal obstruction that can be directly attributed to defined anatomic problems that may be present and that will not be correctable by medical therapy.  Such deformities include deviation of the septum or bone-cartilage pyramid, narrowing of the internal nasal valve or collapse of the external nasal valve.

Mario J. Imola, MD, DDS, FRCSC.

Insurance coverage for nasal airway obstruction is common.  The first step is to get a physical examination and evaluation of your nasal airway.  

Most insurance plans will cover some of the costs for correction of functional problems such as breathing obstruction but will not pay for any cosmetic changes.  Frequently the total out of pocket cost is less if you do everything at one time. Your surgeon's office can help you contact your insurance company.