Will medical insurance cover a deviated septum and will rhinoplasty be covered as well if conditions are bad? (Photo)

Question

Im a 21 year old male with low income and very unhappy with my nose, I often get fun of it, especially with my family. I do have trouble breathing from my nose and don't know if medical will cover it. Is it possible for my nose be straighten and look normal To other people?

David Stoker, MD · Answer

Many insurance companies provide coverage for surgery to treat deviated nasal septums.  Unfortunately many current policies will cover only a small portion of the cost of the procedure. Check with your surgeon's insurance billing office to assess your policy.  Rhinoplasty is almost never covered because it is considered cosmetic. Good luck.

Robert Pettis, MD · Answer

Hello and thank you for your question and photos.  Insurance coverage of a surgical (or other) procedure is usually based on medical necessity, and the determination of medical necessity is often reviewed by the insurance company by requesting records, studies, images and other documentation, and the coverage determination may possibly be made by the insurance company Medical Review Officer.  You may want to contact your insurance company to discuss your medical/functionality concerns and ask them for a referral to a board certified physician and surgeon that is within your coverage network.  
As far as your concerns about your appearance, everyone is a unique individual and the many details of your facial structure are what make you unique.  Look at the many known and admired celebrities with distinctive features-they wouldn't be themselves if they were altered!
All the best to you!

William Portuese, MD · Answer

Medical insurance will only cover breathing problems such as a deviated nasal septum. Medical necessity must be documented at the time of the examination and consultation. Pre-authorization with your medical insurance will also be required prior to the surgery. Anticipate co-pays and deductibles associated with your medical insurance. A rhinoplasty to change the shape of the nose is considered cosmetic, and must be paid for by the patient themselves. There is no medical necessity for  a cosmetic rhinoplasty. Both a cosmetic rhinoplasty and functional breathing surgery can be performed together simultaneously  under one anesthesia which allows one recovery period. For more information about the differences between the two procedures, please see the link and the video below

Will medical insurance cover a deviated septum and will rhinoplasty be covered as well if conditions are bad? (Photo)

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