Will a Septo-Rhinoplasty Be Covered by Insurance?

Cosmetic changes to the nose are never covered by insurance.  Problems which are related to breathing such as a deviated septum may be covered by insurance.  In addition, problems which are related to trauma, such as a crooked nose after a hit to the nose may also be covered by insurance.  

There are many benefits to having surgery which improves breathing and functionality of the nose coupled with cosmetic changes to the nose at the same time:


Patient can have one operation to correct two different issues and therefore one anesthetic and one recovery period

Overall cost is typically much lower to combine procedures than to perform them at separate times

Cartilage which has been removed during the functional portion of the case can be used for the cosmetic case.  Most surgeons "throw away" the cartilage during a septoplasty (I do not).  If this cartilage is removed and thrown away, and a planned separate subsequent procedure would be much more complex and may require either auricular (ear) grafting or costal (rib) grafting

There is some overlap between the cosmetic and functional portions.  For example, straightening a septum (which can be highly complex- see attached link to a paper I wrote on open septoplasty techniques) is often necessary in creating a straight nose from the frontal view.  Failure to address this issue can leave the nose worse off both cosmetically and functionally.


The nose is a highly complex structure and requires a surgeon of expertise in handling both functional and cosmetic issues.  If you do have a functional issue and are considering cosmetic changes as well, it is worth your time to make sure you decide one way or the other before your procedure.  Otherwise, if you seek cosmetic changes later after a standard septoplasty technique (more than 90% of surgeons use a submucous resection technique)  your rhinoplasty will be much more complex.

Hello, Mrs. W.

Good thinking re combining the breathing surgery with the cosmetic surgery.

Insurance covers correction of the deviated septum if it is causing breathing problems. Check with your insurance agent or your companies HR department, regarding the specifics of your policy. Very important; assume nothing.

However, generally insurance covers the breathing operation. It will not pay for the bump removal which is a cosmetic issue. In your favor is that if you add the cosmetic procedure onto the surgical plan, the extra charge for the bump removal should be very reasonable.

Ask the doctor for an exact quote based on what information you and the office get from insurance company. There should be no guesswork.

 

Robert kotler, MD, FACS

Beverly Hills, CA