Insurance Coverage for Nose Hump Removal Due to Injury?

Although your insurance may have paid for the intial repair of the nasal fracture it is unlikely that they will cover the subsequent correction unless there is some functional component. This means that your "deformity" must be causing some breathing difficulties. The likelihood of this is relatively low. To know for certain, see a rhinoplasty surgeon and have trhem complete an evaluation and prepare a letter of predetermination of benefits coverage to your insurance carrier.

 Most insurance companies will only cover this if there is a functional component. You can check with them to get a predetermination of what they will cover.

Traumatic hump deformities from sports related injuries may in some cases be covered by insurance companies especially if there is a concomitant break or deviation of the septum. I have had many patients be able to have this problem corrected who are basketball players at the local university as well as baseball players. That being said we would have to pre-certify the procedure with your insurance company. One thing you can do is check with your insurance company policy to see if it is a covered procedure.
For a non-cosmetic procedure, often an open reduction of nasal fracture with septal fixation is used so you may try that avenue. In my personal opinion, it should be covered since it is the direct result of trauma as long as you are not seeking to have an aesthetic or cosmetic rhinoplasty done with the rest of your nose at the same time. I hope this information helps.

It's unlikely that your insurance company will cover the costs of rhinoplasty, since your predominant complaint is a cosmetic concern, not a functional one. Insurance companies are much more likely to cover some of the costs of rhinoplasty if there is documented airway obstruction or breathing problems. A bump on your nose, although the result of trauma, ultimately is a cosmetic concern.
Hope this helps. Best of luck.

Insurance is a contract between you and your insurance company. I suggest you contact your carrier and ask them if a facial fracture is a "covered" expense and get it in writing.

Be aware however, that insurance companies make money by denying claims. So even if in writing, be prepared to fight.

Some patients get a new bump on their nose after a nasal fracture, even if it was "set" by a closed reduction. This is from what is referred to as a callous. As bones heal they have a bump of healing bone, the callous, which usually goes away after a few months. Sometimes a bump remains. If you can demonstrate by old photos that the bump is definitely new, the nasal fracture reduction was within the past year or so and you have a persistent doctor, this may get covered by insurance. However, any other changes such as tip work is not related.

Insurance coverage will only re-straighten the nasal bones from a documented prior injury. It will not address any cosmetic hump removal even though that was due to the injury. This is considered a cosmetic nose job. If the nose is still crooked and displayed then your medical insurance may cover this.

This is how I handle these situations in my practice. After an in detailed history and physical examination, including 6 photographic views, I request the patient to supply ANY documentation related to the previous injury. This doctumentation is operative reports, office or ER notes and reports, X-ray reports. Anything that will justify the reconstructive portion of the planned operation.
Then we send/call/email/fax ALL this information to the patients' insurance company. Upon a response, in writing, we than review with the patient their 'covered benefits', the out of pocket costs, the non covered costs or cosmetic portion costs. In most circumstances upto 50% is covered by insurance the other is cosmetic costs. So you will have to pay something out of pocket, no free ride. Best of Luck and Regards.

In an ideal world, all defects would be fixed for free. That does not exist. Although you say you are not into Plastic Surgery or a "nose job", I bet your wear nice clothing and try to have a good appearance. That is all that plastic surgery is, we can improve your bump and make your nose look better, if you don't like your appearance. The problem is, you will have to pay for it. Very few insurances pay for nasal bump correction. They may pay for the closed reduction when you hurt yourself but later on, it is up to you.

I am NOT familiar with Michigan medical insurance companies and can only speak to those in Tennessee.
The likelihood of a medical insurance company in Tennessee approving a Reduction Rhinoplasty because of a presumed or more precisely claimed causal relation to a basketball accident is zero. They MAY, depending on your policy, approve a Septoplasty but never a reduction rhinoplasty.
I would be curious what my other colleagues' experiences have been.
Dr. P. Aldea