Does my Nose Need to Be Fixed? Will Insurance Cover This if So? (photo)

You need a more in depth evaluation of the inside of the nose to see what is causing the problems. Insurance usually covers sinus and breathing issues but usually won't cover something that is cosmetic in nature. You need to have a consult with an otolaryngologist who specializes in sinus problems as the first step.

Dear KassandraA,


Your issues with breathing, nasal drip and facial pain should be investigated at your initial consultation

Seek out a rhinoplasty surgeon who has training in sinus issues as well as facial plastic surgery to best address both your medical and surgical issues

Your insurance would cover the functional, breathing problem, portion although it will not cover your cosmetic portion of the surgery


Best regards,

Nima Shemirani

    A deviated septum that is causing obstructive symptoms may be covered by insurance.  Anything else relating to the appearance of the nose will not be covered.  Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

Hi Kassandra:

It is likely you have a deviated septum and some element of nasal blockage due to your symptoms.  “Nasal drip going down my throat” suggests that the air passage through the nose is inadequate.  You need a very thorough exam to determine if not only a deviated septum is responsible, but perhaps enlarged turbinates, nasal polyps or other not serious but significant conditions.  Generally people do not have postnasal drip when the anatomy of the nasal passage is good.

The other issue is separate from the appearance of your nose.  It looks like the tip is a little bulbous compared to a very narrow bridge, or upper half of your nose.  That would require rhinoplasty.  It is certainly possible to perform both the external cosmetic rhinoplasty procedures along with the internal breathing procedures. 

The question comes up regarding insurance payment when there is a combination of procedures.  Most offices will bill insurance companies for the strictly functional operations, such as correction of a deviated septum, trimming of the turbinates, removal of nasal polyps, etc.  But insurance will not pay for the external, purely cosmetic changes.  But it's wise to have both at the same time due to efficiency of your time, with only one anesthetic costs probably passing on significant economic advantages, thanks to insurance most likely covering some portion of the surgery related to breathing and sinus function. 

When you go for a consultation, discuss this with the doctor and the office’s business manager.  Be sure to bring all your insurance information because the office might need to contact the insurance company ahead of time to ask for a “preauthorization” in which the insurance company grants the “green light” to go ahead and perform the procedure.  Remember, no medical office can guarantee payment; that part is up to the insurance company and its evaluation of the claim.  Most offices provide much of the homework and form completion so that the insurance company knows exactly:


   *what was done

   *why it was done

   *how you are expected to benefit from the surgery


All things considered, it's wise to combine both procedures, particularly since there is only one anesthetic and one recovery period. 

Robert Kotler, MD, FACS
Facial Plastic Surgeon
Author, SECRETS OF A BEVERLY HILLS COSMETIC SURGEON
Author, THE ESSENTIAL COSMETIC SURGERY COMPANION
robertkotlermd.com
 

 Insurance will only cover  medically indicated procedures, not to just straighten the nose. a cosmetic rhinoplasty but would be required to straighten the nose bones. Chronic sinusitis is usually caused by allergic nasal polyps which can cause postnasal drip drainage and facial pressure symptoms. A CAT scan is required for diagnosis of the sinuses. Postnasal drip and drainage going down the back of the throat is usually treated Initially with nasal sprays, antihistamines, and decongestants. A deviated septum is located in the back of the nose and when  it is crooked it causes nasal obstruction. A septoplasty is required to repair it when it's deviated enough. For more information about nasal issues please see the resource link below

thank you for your question

unfortunately I don't think anyone will be able to effectively answer your question online particularly with just the one photo. I can see the slight deviation that you are describing but in general it may be doubtful that insurance would cover this. Insurance will most likely cover procedures to improve the breathing function of your nose and function of your sinuses.

Best of luck

Chase Lay, MD

double board certified facial plastic surgeon

Only one posted photo we can not advise if your health insurance will cover. Best to seek IN PERSON opinions!!

Most health insurance companies exclude coverage for cosmetic surgical operations such as rhinoplasty or any complications that might occur from surgery. However, your insurance company may cover your rhinoplasty if you are have funtional problems such as trouble breathing through your nose. Please carefully review your health insurance subscriber-information pamphlet. I recommend that you make an appointment with a board certified plastic surgeon for an evaluation and to discuss your concerns. 

Nobody has to have their nose fixed but if you have trouble breathing or don't like the appearance consult with an experienced rhinoplasty specialist. Insurance will cover functional problems in most cases. The surgeon's office can help you to determine what your insurance will pay.