Will Insurance Pay For A Septorhinoplasty?
Q: Dr. Eppley, I am interested in a septorhinoplasty procedure. I have snoring issues and a previous broken nose. I am curious about price and how much insurance would cover to fix a deviated septum to help with breathing. along with reconstruction surgery to slightly change nose appearance. As far as reconstruction, I would like to make it more defined from the front with a more feminine profile.
A: When it comes to nasal surgery, insurance only provides potential coverage for functional airway issues with the nose. (i.e., breathing difficulties) These include procedures like septoplasty, turbinate reductions and middle vault reconstruction with spreader grafts. Whether they would provide such coverage requires a written pre-determination letter by the evaluating surgeon. For a written pre-determination letter to be considered by the insurance company, a CT scan must first be done to verify that there is internal nasal anatomic derangement. A pre-determination letter that is not accompanied by a CT scan report will be automatically denied.
Insurance will not pay for any cosmetic changes to the outer appearance of the nose. That would be additional costs for the operating room, anesthesia and surgeon’s fee for this type of aesthetic rhinoplasty changes. These are not considered reconstructive regardless of how they developed.
Functional and cosmetic rhinoplasty procedures are commonly done together (septorhinoplasty) with the patient having financial commitments based on the limits of the insurance policy and the extra costs associated with the cosmetic portion. Those exact cost numbers can only be provided now based on what the fees associated with the cosmetic portion.
Dr. Barry Eppley