I was born with a cliff lip, had a few corrective surgeries as an infant. I am now 34 yrs old. Will insurance cover Rhinoplasty?

Question

I was born with cliff lip and had a few corrective surgeries when i was an infant. I am now 34 years old. I have one nostril larger then the other. Is this something that my medical insurance would cover?

Gregory A. Wiener, MD, FACS · Answer

Hi Stacey,  Thank you for your question.  It is very difficult to get your rhinoplasty covered by insurance especially if the surgery is performed by a plastic surgeon.  It is recommended to have your primary physician to help you with this information  and submitting the information to your insurance to see if they would approve it as medically necessary.

Toby Mayer, MD · Answer

Insurance coverage for rhinoplasty in the cleft lip nose is possible if you have a breathing problem. Check with your insurance company first so you don't have any surprises.

James A. Hoffman, MD · Answer

Because your corrective surgery is related to your cleft lip it may be covered by insurance. Most insurance companies will cover this through age 18. Talk to your Surgeon's office about seeking authorization for coverage. It will depend on the company and the type of policy you have now.

William McClure, MD · Answer

Thank you for your question. Most of my cleft lip patients will undergo a rhinoplasty during their teen years. This typically is the last operation they will require. It has been my experience that most insurance plans will cover this. Please make sure your plastic surgeon is board certified and has an expertise in rhinoplasty. Your surgeon's office staff should be able to help you obtain insurance authorization. Best wishes.

Steven Wallach, MD · Answer

It is difficult to get approval for rhinoplasty surgery these days, but cleft lip and palate surgery should have some coverage. Best to check with your insurance company.

Remus Repta, MD · Answer

Dear Stacey,It depends largely on your insurance carrier and your policy.  Since your nose shape is secondary to a congenital deformity there is a chance your insurance may cover the nose reconstruction component.  This is especially true if you have breathing difficulties as a result of your nose shape.All the best,Dr. Remus Repta

Brooke R. Seckel, MD, FACS (retired) · Answer

yes, insurance should cover rhinoplasty to correct associated nose changes caused by a cleft lip.  This is considered reconstructive surgery.  Ask your surgeon to apply to the insurance company for prior approval.

Richard W. Fleming, MD (retired) · Answer

Hopefully your insurance company will help you with the cost of your operation but we cannot answer your question. Your surgeon's office should help you discuss this with your insurance company before the procedure.

Donald Nunn, MD (retired) · Answer

In general insurance will not cover rhinoplasty surgery.  The one exception is for treatment of the cleft/lip palate patient which has a nasal deformity due to the cleft.  But even with this every insurance is different and preauthorization is advised.  Good luck.  Donald R. Nunn MD  Atlanta Plastic Surgeon.

I was born with a cliff lip, had a few corrective surgeries as an infant. I am now 34 yrs old. Will insurance cover Rhinoplasty?

Answers (9)

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