The growing interest in functional and cosmetic rhinoplasty raises numerous insurance coverage questions. Most policyholders wonder whether their health insurance can pay for all the aspects of such a surgery. And it is only natural since nose reshaping keeps leading the list of the top surgical procedures in the United States.
Before deciding to undergo rhinoplasty surgery, you need to understand which conditions guarantee coverage and which factors influence the coverage capacity.
Gone are the days when getting a nose job was shocking. And while it still might cost you a pretty penny, aesthetic and functional surgeries are now the new normal. Case in point: in 2020, the number of rhinoplasty procedures exceeded 350,000. And this amount only reflects the ones performed by ASPS members.
But what about coverage options? Is it possible to cut your out-of-pocket expenses when it comes to specific types of facial plastic surgery? It sure is, especially if you are planning to undergo a medical rhinoplasty procedure.
Rhinoplasty, otherwise known as a nose job or a deviated septum condition, implies reconstructive and restorative services aimed at improving the functions of your nose.
But bear in mind that this term is often used to describe any nose reshaping surgical procedures. So talking to the medical professional can be a good call if you want to get your facts straight.
How do you know if you need this surgery? If you have trouble breathing, keep waking everyone up by your loud snoring, experience nose bleeds, or sleep apnea, you might have a deviated septum. But let’s be honest: only a doctor can run diagnostic testing and accurately determine the cause.
Naturally, mild symptoms might not seem like a reason enough to see a doctor. However, if you have been putting off your routine medical examination and recognized some of the symptoms, it’s time to reconsider.
Policyholders often do not have enough information about the extent of their coverage when it comes to complex operations like fixing a deviated septum.
If you find yourself wondering about covering different aspects of the procedure, you need to contact your insurance company first. The provider will inform you of all the details and explain what your plan can cover.
If the information you got from the insurance provider does not seem sufficient, you can talk to the benefits expert. This way, you can address the remaining concerns before the procedure.
Contrary to popular perceptions, there is no such thing as too many questions, especially when dealing with health issues. With this in mind, we have put together a shortlist of the most common questions on the matter.
Generally, elective surgeries that do not imply emergencies, like cosmetic rhinoplasty, are not covered. Here’s the thing: there are two principal reasons for an operation — functional and aesthetic.
It is not uncommon for patients to wish to fix the inside and the outside of the nose. However, the medical necessity typically prevails.
If you are dealing with the medically necessary treatments or aspects of the procedure, you should expect your plan to cover them.
That is one of the burning questions every policyholder contemplates over and over again. As mentioned earlier, most functional treatments can and will be covered by your plan. However, in some individual cases, you might have to bear the costs associated with narcosis, post-operative treatments, night shifts, etc. That is why you need to ask your doctor about all the related fees before the operation. And afterward, get in touch with your insurance provider.
The first step would be to prepare all the information about your medical condition and your current coverage. There is only one rule here: learning and bringing as much relevant information as you can. That is the only way to ensure a productive conversation.
What is relevant information? Well, it typically includes your diagnosis, test results, other relevant health records, your tax ID, insurance code, and the name of your doctor. If you do not know how to obtain this information, consult a dedicated medical expert.
First of all, these procedures cannot be performed or scheduled together. The same applies to billing. For example, if you had your jaw reshaped and burn injuries treated simultaneously, your insurance would cover only burn-related expenses. Why? Well, any aesthetic treatment or surgery is elective, which means that it is not an emergency. And therefore, you can live without it.
For practical reasons, such procedures are kept separate. Since the bills include much more than only the surgery itself, you can only end up saving money if you are suffering from a specific condition. Any aesthetic procedure will likely cost twice as much. It means that, without coverage (since there is none), you will have to bear all the costs.