Insurance Dollars for Rhinoseptoplasty

In recent years many celebrities have explained going under the knife for a nose job by stating it was a performed for medical purposes.  So it’s no surprise that I have been asked various times by patients about the likelihood that their insurance plan would cover the surgery. 

It has been my experience that it behooves the surgeon to obtain pre-authorization for the surgery from the specific insurance company as they all have varying policies.  The third party will usually pay for medically necessary surgery, provided that the appropriate medical documentation to support necessity of the proposed surgery is available.   If there is associated trauma to the nose, the third party will often pay for reduction of a nasal fracture more readily than pay for a rhinoplasty.   Third parties typically deem rhinoplasty a cosmetic surgery.  They regard septoplasty and turbinectomy as medically appropriate surgeries performed for medical necessity.

Septoplasty and turbinectomy procedures are performed to improve breathing; therefore third parties tend to pay for these procedures.   However, if a rhinoplasty is performed at the same time, the third party will deny payment for the cosmetic portion of the surgery---- the rhinoplasty, including anesthesia and operating room fees incurred during the cosmetic portion.

There are always exceptions to the rule, but it is better to expect that there is a very small likelihood that your insurance will cover your rhinoplasty.   The best course of action is to talk to your surgeon about what your options are and what payment alternatives exist.