Would insurance cover my turbinate reduction and rhinoplasty?

Question

I have swollen turbinates and was thinking of getting surgery for it so I could breathe easier, but I also was looking into getting rhinoplasty surgery as well, so would the insurance that covers my turbinate procedure also cover my rhinoplasty procedure, or part of it?

Jamil Ahmad, MD · Answer

When combining a function procedure/medically necessary procedure (turbinate surgery), with a cosmetic procedure (rhinoplasty), it is best to discuss the specifics of what is and isn't covered with your surgeon and insurance provider. Health insurance plans vary greatly in what is covered and how much out of pocket expenses (deductibles) you will incur. It is best to get these details clarified before committing to surgery.

Kenneth Hughes, MD · Answer

The turbinate reduction will be covered, and the external anatomy correction 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

David C. Pearson, MD · Answer

While the functional aspects of surgery such as turbinate reduction are billed to the patient's insurer, the cosmetic component--the rhinoplasty--is the patient's financial responsibility. As such, the main advantage of combining procedures is not so much one of financial cost (though it may be a bit less) as one of the cost of healing and downtime. It makes sense to combine both procedures and thus minimize the time away from work/school and have only one period of discomfort from nasal surgery rather than two.

	All the best,

	--DCP

	Pearson Facial Plastic Surgery®

Richard W. Westreich, MD · Answer

I generally keep things as separate as possible, as to avoid any confusion for the patient and the carrier.

	Cosmetic is Cosmetic, and it should not be billed to an insurance company under a functional umbrella. You are only asking for trouble if you do that. It is likely that the carrier will review the clinical information and deny the whole case, leaving you with the entire bill. From a provider standpoint, it really is fraudulent to do so.

	That being said, insurance can and should pay for functional surgery. Taking this approach, patients will generally avoid >50% of the facility/anesthesia fees and a portion of the professional fees. It can make a substantial impact on cost to combine functional and cosmetic surgery into a single procedure.

	This approach also allows the doctor to give you a concrete number for your out of pocket costs, rather than a situation where you may get reimbursed if and when your insurance pays out. 

	Best of luck and hope it works out for you

Vincent N. Zubowicz, MD · Answer

Insurance will probably cover the functional operation on your airway. It is unlikely that it will cover the cosmetic rhinoplasty. These two operations are commonly done together.

Toby Mayer, MD · Answer

Insurance will cover terminate and septal deviation portions of your nasal surgery. It does not cover cosmetic rhinoplasty.

William Portuese, MD · Answer

There are multiple issues inside the nose that can all cause nasal obstruction which include turbinate hypertrophy, allergies, valve collapse, and a deviated nasal septum. Each one of these are treated differently. Best to let your ENT/facial plastic surgeon make the diagnosis after consultation and examination. Any functional surgery his billed the patient's medical insurance for medical necessity. Any cosmetic surgery is paid for by the patient themselves. Both procedures can be performed under the same anesthetic with same recovery period.

Would insurance cover my turbinate reduction and rhinoplasty?

Answers (7)

More Rhinoplasty Questions

My Nose Appears to Droop on One Side and I Also Think It is Too Big. What Can Be Done? (photo)

When can I get back to the gym after a rhinoplasty?

Broken Nose I Had 2 Black Eyes. but Ive Still Got One Black Eye Its Been Like This for 3 an Half Weeks. Wil It Stay Like This?

L Shaped Silicone Vs Gore-tex? I'm at a Dilemma.

Can I Wear Contacts After Rhino?

Is a tip-rhinoplasty possible for me?

WE SEND PRETTY
EMAILS