Will my Insurance Pay for Rhinoplasty to Correct a Crooked Nose?

Question

My nose has been crooked for as long as i can remember.I don't have trouble breathing or anything,but it effects my self asteem greatly.I currently have Medicaid insurance,but i am willing to pay for the procedure,although it would be great if my insurance would cover it. thanks, Dean

Jerome Edelstein, MD · Answer

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

Etai Funk, MD · Answer

This is a common question asked by patients. The answer is it depends. What caused the crooked nature of your nose? If you had recent trauma and this was documented by the same physician that is planning on performing your procedure, insurance may cover your surgery. However, if you had trauma to your nose 10 years ago and now want insurance to cover your rhinoplasty, they likely will not. Most patients want other aspects of their nose enhanced in addition to straightening it (tip refinement, hump removal). These will not be covered by insurance.

Ali Sajjadian, MD, FACS · Answer

Hi,

	These are some of the nasal conditions which are going to be covered by insurance:

	1. Nasal breathing difficulty, Septal deviation, Turbinates enlargements

	2. Sinus problems

	3. Deviated nose, twisted nose, or nasal fracture

	Best,

Michael A. Persky, MD · Answer

Hi Christina,

	Unfortunately there were so many rhinoplasty surgeons in the 60's and 70's who abused insurance coverage of rhinoplasty by fabricating "nasal breathing" problems in their patients and having the surgery covered as septorhinoplasty, that today insurance companies are very resistant to pay for even necessary surgeries. You may be able to get some insurance compensation for septoplasty-rhinoplasty, but only if your insurance company investigators never find your question here on RealSelf.  Insurance will only cover surgical expenses for correction of functional breathing problems, not for cosmetic related issues.  Good luck and be well.

	Dr. P

Jon E. Mendelsohn, MD, FACS · Answer

When a "functional" problem exists with the nose (such as a breathing problem, sinus problems, nosebleeds etc.,) insurance may cover the surgical procedure necessary to address the problems.

However, it is extremely difficult these days to predict what is covered as insurance companies vary so much.

In your case, it may also depend how you sustained the deviation of you nose as well as the timing from the event.

Jacob D. Steiger, MD · Answer

The nose has two roles on our faces, form and function.  It is important that both be addressed whenever a rhinoplasty is performed.  Insurance does not cover the cosmetic portion of the procedure.  However, if you have any difficulty with breathing through your nose, that functional portion can be covered under insurance.

	If you are having nasal obstruction, it is best to seek the advise of a nose specialist in order to help ascertain the cause of this and come up with a solution. Be sure that the surgeon you find has experience with cosmetic changes to the nose as well.

Steven Wallach, MD · Answer

I donot believe Medicaid would pay for you twisted nose, but you can check with them for their criteria.

Peter A. Aldea, MD · Answer

Regarding: "Will my Insurance Pay for Rhinoplasty to Correct a Crooked Nose?
	My nose has been crooked for as long as i can remember.I don't have trouble breathing or anything,but it effects my self esteem greatly.I currently have Medicaid insurance,but i am willing to pay for the procedure,although it would be great if my insurance would cover it."

	Medicaid is not "real" insurance. It is the most basic of medical coverage intended to pay only for life and function affecting diseases for people earning income in the poverty range. A twisted, breathing nose poses not functional threat and its repair will never be paid by Medicaid. Repairing your nose is a cosmetic operation that you have to pay out of pocket.

	Dr. Peter Aldea

Ryan Heffelfinger, MD · Answer

This depends on many factors, including your insurance company, the doctor you are seeing, and your deformity. Unfortunately, I have found that Medicaid almost never covers a pure rhinoplasty. But, they will cover a fracture repair, septoplasty, and other functional procedures. In my experience, if you are seeing a purely cosmetic surgeon, they are generally not going to go to the trouble of trying to get your surgery covered. With a large reconstructive practice, my office is used to precertifying surgeries, and we will attempt to get nasal surgery covered whenever appropriate and medically necessary. Some insurance companies require there to be a documented history of nasal trauma, sometimes within a specified time period (ie within the past year). Good Luck!

Richard W. Fleming, MD (retired) · Answer

It is unlikely Medicaid will pay for correction of your crooked nose, but your surgeon can help you try to get a pre-operative authorization from your insurance company.

Will my Insurance Pay for Rhinoplasty to Correct a Crooked Nose?

Answers (11)

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