Insurance Cover Rhinoplasty or Nose Job Surgery?

As pointed out by other surgeons, the answer to this question can get very complicated.

Your health insurance plan should cover any nose surgery (including surgeon fees, anesthesia and facility costs) that is done with the specific intention of improving your nasal breathing and/or repairing structural damage from a nose injury. Of course, obtaining pre-authorization from your insurance carrier is always recommended. This means the proposed surgical procedure and indications for the surgery are presented to your insurance carrier in advance. They review the documentation provided and respond accordingly whether or not they feel the surgery is medical indicated. If the answer is yes, they will usually provide coverage (payment) for those procedures requested.

Anything done during that surgery that is intended to reshape the nose for cosmetic reasons is not covered. This includes any supplies used and anesthesia given during that time devoted to the cosmetic portion of the surgery. Consequently, you will be responsible for paying out of pocket for the surgeon fees, anesthesia and facility costs for this portion of the case. Although you are already asleep under anesthesia for the functional surgery, the anesthesiologist is required to bill you separately for the time spent under anesthesia for the cosmetic reshaping.

Usually the total cosmetic fees (surgeon, anesthesia and facility combined) are discounted when done in combination with insurance procedures. However, you as the patient need to be mindful that you are still responsible for any and all deductibles and copays triggered by your health plan. Some patients have a low deductible while others have a high deductible. This can significantly impact how much you end up paying in total for both the functional surgery and the cosmetic reshaping. Make sure to read your individual policy very carefully and ensure that you understand the terms of your policy in detail. This can be the source of much disappointment in some cases.

Insurance would cover the septoplasty if it is medically necessary. However, it will not pay for the bump removal or any part of the rhinoplasty. The cost will vary from surgeon to surgeon but usually ranges between $5000 and $10000. Be sure to see a rhinoplasty specialist for consultation.

Good question.  This is a common question we get in the office.  IF insurance will pay it only pays for FUNCTIONAL issues.  That is issues that affect the function of your nose like breathing.  All aesthetic issues like humps and tips are not covered by insurance.  As for costs it varies from surgeon to surgeon and depending on the degree of cosmetic change you desire.  Best option is to go and see a surgeon in person and allow him to help you

It’s not unreasonable to seek prior authorization from insurance carriers for rhinoplasty and septoplasty when these deformities are associated with trauma.  In addition, deviated nasal septums are often associated with nasal airway obstruction.  Under these circumstances insurance carriers will often cover the expense associated with this procedure because of its functional significance.

            Unfortunately, if nasal deformities aren’t associated with trauma, they’re unlikely to be covered by insurance carriers.  Under these circumstances, the expense of rhinoplasty, including anesthesia, would be the patients responsibility for this portion of the procedure.

            If you have questions regarding this issue, it’s important to discuss them with your surgeon.  Your surgeon should be able to answer your question and clarify this issue.

Insurance questions are best addressed by your insurance policy provider. Pure Cosmetic Surgery is not usually medically necessary nor a covered expense. It's best to review your insurance policy and see what's covered. Prices vary from Practice ti Practice, experience of a Surgeon, etc.

If you have a nasal bump and a crooked nasal appearance with a deviated nasal septum, having your functional and cosmetic concerns addressed at the same surgery may be best. Insurance coverage of your functional issues may be covered depending on your insurance policy, and your surgeon's participation with your insurance. Consider consulting with several rhinoplasty specialists so you could see what to expect after surgery. You can check local fees for service here on RealSelf. Thank you. Dr Joseph

Hello! Thank you for your question! Surgical procedures for aesthetic
purposes, to improve appearance, are not covered by insurance.
Typically, these as well as complications resulting from such procedures
are the responsibility of the patient. Procedures that are meant to
correct functional issues and those which cause health-related issues
should be covered by your insurance as a medical necessity, with proper
examination and documentation. Some insurance plans have exclusion
criteria for certain procedures. Also, it is an obligation of the
surgeon not to attempt to authorize purely cosmetic procedures through
insurance.  Your septoplasty portion, which is causing you a functional deficit of breathing is certainly something often covered.  However, the aesthetic changes to your nose are not.  The facility fee and anesthesia fees should begin once the insurance procedure ends.  Depending on the amount of work needed for the rhinoplasty will determine the cost.  This will also vary among surgeons as well as your geographic location.  Discuss your issues and
complaints with a board-certified plastic surgeon to discuss these as
well as to examine and assist you in deciding which procedure(s) will be
the best for you. A discussion of the advantages and disadvantages will
take place along with the risks and benefits. Insurance companies will
vary on coverage and is always reasonable to discuss your issues with
your surgeon and primary care. It would behoove you to get as much
information as possible and even call your insurance yourself.
Certainly, pay in advance prior to your surgical procedure and options
such as financing are available if you qualify. Hope that this helps!
Best wishes!

How much insurance will pay for nasal surgery is a very gray area. This is especially true when there is a functional component.
A septoplasty does not change the shape of the nose and is therefore considered a functional procedure as opposed to a cosmetic procedure. As such, it is a procedure that insurance should pay for (as well as facility fees and anesthesia costs). Verification of benefits and prior authorization before surgery should be obtained.
Rhinoplasty is considered a cosmetic procedure. It is very unlikely that insurance will contribute to that portion of the procedure. Even though the rhinoplasty portion of your surgery will be considered cosmetic, the functional component will be covered by your insurance and may decrease your out of pocket expense.
However, for patients with a history of prior nasal trauma and documented symptoms of nasal obstruction, a septorhinoplasty may be covered by your insurance. This terminology denotes that the surgery is performed to correct funcational problems and required reshaping the nose.
Choose a rhinoplasty surgeon who has experience in correcting both functional and cosmetic nose problems. Check to see if the physician's office can assist with your arranging your insurance pre-authorization.

Great question. The deviated septum and any functional breathing problems you may have may be covered by insurance, but the dorsal hump removal would not be, as that portion is cosmetic. Normally, when cosmetic cases are combined with reconstructive problems, insurance will pay for anesthesia, fees, etc. of the reconstructive part (deviated setpum), but will not pay for the anesthesia, fees, etc. associated with the second half of the procedure, which is the cosmetic portion. How much that costs depends on your surgeon, the city you live in, how long it takes the surgeon to do the cosmetic portion of your case, etc. It could range from as low as 5,000 to as much as 20,000 or so, though there could be some surgeons outside of this range.
-David Mattos, Harvard trained plastic surgeon

 A deviated septum is performed only for functional purposes to improve airflow dynamics through the nose, and will not  change the appearance of the nose. Medical necessity and preauthorization with your insurance must occur prior to any functional nasal surgery. Cosmetic nasal surgery is performed to change the shape of the nose, such as removing the dorsal hump. A septoplasty and rhinoplasty are two completely separate procedures, however both can be performed under one anesthesia with one recovery period. Expect to pay for the cosmetic component yourself. Anticipate paying for insurance co-pays and deductibles associated with the functional surgery. Your medical insurance will not cover anything related to the nasal  bump correction. For our current rhinoplasty pricelist, and more information about the differences between a septoplasty and rhinoplasty, please see the link and the video below