Insurance Coverage for Functional Rhinoplasty

Last December, my daughter had a Rhinoplasty to fix collasped nose (nasal airway). She was born with cleft lip. Insurance company paid her Anesthesiologist but they are refusing to pay surgeon and hospital bill totaling $9600. Cigna is saying my employer medical plan does not cover Rhinoplasty. Can anyone give me any suggestion how to make Cigna pay for these bills? Thanks.

Doctor Answers 3

I would talk to a supervisor.

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 This is a functional problem and in my opinion should be treated as such. If you still don't get resolution you can call the insurance commission in your state.  You can contact the television consumer affairs reporter in your area.

Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Talk to your state insurance commissioner

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Insurance companies typically do not cover any cosmetic surgery such as a rhinoplasty. Check with your insurance plan and look for coverage under congenital deformities such as a cleft lip nose. One suggestion would be to consider talking to your state insurance commissioner to help guide through the process of assist in payment for a congenital deformity. Whether or not they will pay for it is spelled out in your insurance booklet.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Insurance comission

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I agree completely. You should skip dealing with Cigna directly. This will not be fruitful. Proceed directly to the insurance comssion. They can be very helpful and have aided my patients (here in WI) more than once.

Benjamin C. Marcus, MD
Madison Facial Plastic Surgeon
4.7 out of 5 stars 46 reviews

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