Will Insurance Cover Rhinoplasty After Accident?

Saturday while playing basketball a girls head collided with my nose and broke it. It is curved and my septum is deviated. I did go to the emergency room and they took xrays. Yesterday I went to the ear, nose, and throat doctor. He said insurance may not cover getting it fixed. Why would that be so?

Doctor Answers 10

Insurance coverage

Insurance generally covers procedures that are to improve function and your health, but not those that are just for aesthetic purposes. Your septoplasty may be covered. You should ask your provider directly, however.

Toronto Plastic Surgeon
5.0 out of 5 stars 179 reviews

Crooked nose and insurance coverage

If your nose is crooked or you have difficulty breathing, then there is a good chance that your insurance company would cover the costs of your surgery. We are also offering a temporary economy price reduction on all cosmetic surgery. Watch the video.

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.4 out of 5 stars 27 reviews

Insurance covers what is medically necessary

Insurance will never cover a rhinoplasty. An accidental fracture of the nose is submitted to medical insurance. Most of the time when the nose is broken a deviated septum occurs at the same time. X-rays will document the fracture, but it is not always conclusive. As long as you have an injury report, accompanying x-rays, and physical examination from your doctor, the medical insurance should pay for the procedure. Any surgery on the nose for cosmetic purposes is not covered by a medical insurance plan. Simple straightening and realigning the bones from a break should be covered.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Insurance Payment for Repair of Broken Nose

If there is a change in appearance or function, insurance companies will usually pay to restore a nose to it's pre-trauma status. Your surgeon caqn request  pre-operative authorization and ask how much your company will pay for the surgery.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 39 reviews

Nose job and/or nasal fracture coverage by insurance companay (= functional rhinoplasty)

Increasingly insurance companies will cover functional and NOT reconstructive surgery. IF the insurance company labels your repair as non-functional, this designation may indicate that it is not eligible for coverage benefits.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 82 reviews

If the X'rays demonstrate a nasal fracture you should be covered

If the X'rays taken in the E.R. demonstrate a new nasal fracture then I too would expect the Insurance to cover some if not all the costs depending on your specific policy. As well, the existence of a deviated septum in conjunction with a new or long standing history of breathing difficulty should gain you some coverage.

David A. Ross, MD (retired)
Chicago Plastic Surgeon
4.6 out of 5 stars 89 reviews

Insurance Coverage for Broken Nose Surgery after Injury

Benefits vary for each insurance provider and plan participant. Generally, acute trauma or injuries are covered by insurance plans, such as restoring a broken nose via a closed or open reduction soon after the injury. However, rhinoplasty to change the appearance of the nose long after the initial injury may not be covered. Speak with your insurance provider and nasal specialist to determine appropriate options. Best of luck.

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews

Insurance will cover a broken nose.

But when it comes to how much they will cover, that is different for each insurance company. You can have your surgeon get an estimated dollar coverage from the ins. company.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Yes and no

Insurance usually covers a "closed reduction" - this is where the curve or deviation of the nose is corrected. It does not narrow the nose or get rid of a bump - it is purely to put the nose back to where it was before the injury.

If you want a cosmetic rhinoplasty it is not covered by insurance.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

The Vast Majority of Insurance plans DO pay for Nose Repair

Sounds like you need a closed reduction of your nasal fracture. I cannot speak for YOUR policy or the ENT's experience with plans in Alabama but in western Tennessee we have had no problems having insurance companies pay for restoring an injured nose back to its former condition. This is NOT Cosmetic Surgery. This is Reconstructive surgery.

Since there is a time window on when the bones can be shifted back to their rightful positions, you may want to call your Insurance Customer Service and even the Insurance Commissioner in your state to set matters clear. You may also check with ANOTHER plastic surgeon. He may feel differently about it.

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 109 reviews

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.