I just went to the ENT and found that I have a slight deviated septum and moderately large turbinates, which he thinks swell at night, causing my bad nighttime breathing. He gave me nasal spray and nothing gets better, I *might* get surgery. The thing is- I want a rhinoplasty anyway. But I need the insurance company to help pay for some of it. Would they pay for some things even though my deviated septum is only slight? Should I see a plastic surgeon instead?
Would I Be Able to Get a Rhinoplasty Covered at Least Somewhat by my Insurance Company?
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Doctor Answers 11
Insurance Does Not Cover For Aesthetic Surgeries
With a "slight" septal deviation not causing considerable breathing problems hence falling into the category of "legit" health issue, I doubt that health insurances would be able to contribute to any aspect of your surgery.
That being said, aesthetic surgeries are to be covered by the patient entirely.
Pease remember that commendable results require an exceptionally skilled surgeon to perform the surgery and settling for anything less than that increases the chances of additional corrective surgeries dramatically.
I hope this helps and please feel free to check the website below.
Thank you for your inquiry.
The best of luck to you.
Insurance coverage and rhinoplasty
A very slight deviated septum does not need to be fixed. Very enlarged turbinates may need to be addressed and this is billed to the patient’s insurance. Any and all cosmetic surgery must be paid for directly by the patient and is not billed to a medical insurance company. A rhinoplasty is much more complicated than turbinate surgery and will take longer to perform and is paid for by the patient.
Insurance coverage for rhinoplasty
Nasal surgery which improves the function of the nose will typically be covered by insurance. Any portion of the procedure which is for cosmetic purposes is paid for by the patient.
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Insurance Coverage for Rhinoplasty
Insurance will sometimes pay for nasal surgery if it is necessary to repair damage caused by trauma or to correct problems with nasal function. Your surgeon's office can help you contact the insurance company for pre-surgical authorization.
Rhinoplasty and insurance
Your insurance company may pay for issues related to breathing problems. Otherwise you will have to cover the rest.
Insurance pays for functional aspects only
Your insurance will pay only for the surgical procedures which help your breathing to improve (for example the septoplasty and turbinate reduction). Insurance will not cover the cosmetic part of the surgery. It may be confusing for you because these may all be done in the same operation. You need to think of it like you are having several operations under one anesthetic.
Is rhinoplasty covered by insurance?
Functional rhinoplasty is typically covered by insurance. Functional rhinoplasty refers to rhinoplasty that is designed to improve the function of the nose. Typical conditions that qualify for a functional rhinoplasty include a deviated septum, turbinate hypertrophy, valve collapse, trauma, or other conditions that impair the flow of air through the nose.
Cosmetic rhinoplasty refers to rhinoplasty that is performed to improve the look of the nose. It does not have any effect of the function of the nose. Conditions would include hump on the bridge of the nose or tip problems.
You would need the surgeon's office to pre-authorize you for the procedure and find out what exactly is covered by your insurance. After this is determined they can give you a quote for what the surgeons fees and surgery center and anesthesia fees will cost.
Rhinoplasty with septum, etc. is covered by insurance for crooked noses.
Rhinoplasty with septum, etc. is covered by insurance for crooked noses with deviated septums and hypertrophied inferior turbinates. How much depends on your carrier and the policy.
Getting nose surgery covered by insurance
It is common for insurance companies to cover function nasal breathing surgery such as septoplasty and turbinate reduction. Your doctor's office would likely want to get pre-authorization from your insurance to see what is covered. It does make sense to have the cosmetic surgery done at the same time as the functional nose surgery. You would want to make sure that your surgeon has experience with both aspects of surgery.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.