Does Health Insurance Cover a Nose Job?
If you are unhappy with the shape and size of your nose, you might be exploring surgical options such as rhinoplasty. Commonly known as a nose job, a rhinoplasty is a cosmetic surgery procedure that is used to reshape a patient’s nose.
Patients seeking a nose job often ask if it is covered by health insurance. The answer is that it depends on your specific requirements and the terms of your health insurance plan.
As a general rule, most cosmetic surgery procedures meant to solely improve your appearance are considered elective surgery and are not covered by health insurance companies. In other words, you are required to pay for all the associated costs of the surgery, which includes surgeon and hospital fees, facility costs, anesthesia, and supply costs, among others.
How much does rhinoplasty surgery cost?
According to the American Society of Plastic Surgeons, the cost of a rhinoplasty is dependent on a variety of factors. From the surgeon’s fees, which are based on her skill set and experience, to the location of the hospital, the amount of structural change required, and more, the dollar amount can be anything from $3,000 to $8,000+.
Given such a variation in numbers, it is important for anyone seeking to reshape their nose to do some in-depth research. Not only should a patient know exactly what the procedure entails, but they should also closely examine the credentials of the surgeon chosen and the record of the hospital.
When does health insurance pay for rhinoplasty?
Health insurance for nasal surgery has huge grey areas. Individual health plan terms, benefits language, and state-level mandates all play into this decision. Health insurance companies closely scrutinize any surgery that is remotely associated with improving one’s appearance. So, if you are looking to get a bump removed or a chiseled nasal line, you are out of luck on having it done on the insurance company’s dime.
However, any nasal surgery that is required to improve your breathing or to correct any structural damage caused to your nose due to an accident or injury will likely be covered by your health insurance plan. The extent of coverage will depend on your insurance plan terms and conditions. Additionally, if nose surgery is recommended to correct a birth defect such as a cleft palate, your health insurance plan might cover the costs.
Will health insurance pay for a combined function-corrective procedure?
If you are suffering from breathing issues caused by a deviated septum that requires surgical correction, it is likely to be covered by health insurance. But in most cases, any additional cosmetic surgery for reshaping or resizing your nose will cost extra. These additional charges are your financial responsibility and include surgeon’s fees, facility charges, and anesthesiologist fees.
In some cases, if you have a documented history of prior nasal trauma, breathing issues, and nasal obstruction that requires functional correction and the reshaping of your nose, insurance companies might consider coverage.
Given that you are getting two procedures done in one go, you could discuss getting a discounted bill with your surgeon.
What are my options for payment for a rhinoplasty?
The first thing to do is to talk to your health insurance company. Before picking up the phone to talk to your agent or your company’s benefits personnel, scrutinize your insurance plan carefully for all the terms and conditions.
If you have some possibility of coverage, talk to your surgeon and ask for a proposed surgical plan and documents supporting required surgery. Submit the paperwork for pre-authorization to your insurance carrier. They will review your papers and will let you know if coverage is available.
If it is, then the health insurance company will cover all costs connected to the procedure requested. You are required to pay all related co-pays and deductions. However, if your request is denied, you will be required to pay all costs out-of-pocket. But if you have decided on getting a nose job even if the cost is prohibitive, you might have some other options.
Many surgeons and plastic surgery centers are offering different kinds of discounts and financing plans. They might be willing to create a monthly payment plan or offer no-interest financing.
If you are interested any other cosmetic surgery procedure, such as liposuction or lesser procedures such as microdermabrasion, you might get an attractive package deal. Talk to your surgeon and see what they can offer.
Additionally, hospitals are also increasingly getting into the beauty business and may provide you with a more affordable plastic surgery option. They are creating packages that allow them to use their facilities to train new surgeons.
In these programs, a surgeon who is a recent graduate of a medical program but is training to advance his or her plastic surgery experience and skills, carries out the procedure. While there is a risk of being under the scalpel of a less-trained surgeon, these surgeries are always carried out under the supervision of a Board-certified plastic surgeon.