Will Insurance Cover Medical Portion of Rhinoplasty?


When you think about rhinoplasty, the first thing that comes to mind is a nose job to improve the appearance of your nose. However, if that is the last thing on your mind. Your nose looks fine.

From the outside, it’s a normal nose that doesn’t take away from your facial features. You aren’t interested in changing the way that you look. You have another problem with your nose. You’re dealing with breathing problems. Your nasal passages always feel like they are plugged. You’re the victim of serious, chronic sinus infections. Your sinus headaches are unbearable. You deal with pressure pounding in your forehead, around your eyes, and even in your cheeks. It even hurts to touch your face. Your sinus pain is the worst when you wake up, your nose is plugged to the point that you can’t breathe, and your face is killing you. You need to find a solution. Rhinoplasty could help you, but the cost is an issue.

Will Your Health Insurance Cover the Medical Portion of Rhinoplasty?

If you are considering rhinoplasty for cosmetic purposes, your health insurance provider is not likely to cover any portion of your procedure. However, it is a different story if you require functional rhinoplasty. Functional rhinoplasty is designed to improve your ability to breathe and relieve discomfort by addressing issues with your nasal airways. Your health insurance company should cover at least a portion of your procedure if it is considered medically necessary in order to improve your breathing ability. In some cases, your insurance may cover all of your costs. It depends on your insurance company and your personal policy.

Who is a Candidate for Functional Rhinoplasty?

Functional rhinoplasty may be the answer for you if:

  • You have chronic sinus problems, including infections, that have a negative impact on your breathing
  • You have a deviated septum
  • You experienced trauma to your nose
  • Your nasal passages are extremely narrow, obstructing airflow
  • Chronic, severe allergies have caused your portions of the inner anatomy of your nose to become enlarged
  • A previous rhinoplasty procedure has led to complications that have impacted the proper functioning of your nose

The key rule of thumb to remember with any insurance company is that they will be looking for procedures that are necessary to improve your health. Unless you have cosmetic surgery insurance as an additional policy, don’t expect your insurance provider to cover a cosmetic rhinoplasty procedure. If your procedure is going to combine cosmetic and functional rhinoplasty, you may find that your insurance company will provide partial coverage for the portion of your surgery that is necessary to improve the functioning of your nose.

Discuss Your Coverage Plan After You Have a Diagnosis

Once you have a diagnosis and know that you need a functional rhinoplasty procedure, you need to talk to representatives with your insurance company to find out exactly what is covered under your policy. Your policy will depend on what your employer offers or what you have chosen for yourself. You have to remember that copays and deductibles may play a role in your final costs for your procedure. If you have any difficulties dealing with your insurance provider, ask your plastic surgeon to vouch for you and the need for your rhinoplasty procedure. With the guidance of your surgeon, you may find that your health insurance provider will be more accommodating about your procedure.

Remember that Financing Options are Available

If you find that your health insurance company won’t cover your procedure or it will only cover a portion of your surgery, there are financing options that can make your procedure possible. Your plastic surgeon will offer you options to finance your procedure. You can also seek outside assistance from lenders or your local bank. There are credit card options that are intended for surgical procedures. If your health insurance company closes the door on your procedure, be open to other solutions. You’ll thank yourself when you are able to breathe more freely again.

What Can Functional Rhinoplasty Do for You?

Whether you always feel congested, you are suffering from sleep apnea at night brought on by blocked nasal passages, you never feel like you breathe easily through your nose, or you are struggling with chronic sinus issues, functional rhinoplasty can change your life. Allergies and sinus issues can be treated, but the effects may only last a short time or be unsatisfactory. When you are looking for a treatment that goes beyond antibiotics and allergy medication, you may need to focus on the inner structure of your nose first. Once the inner anatomy of your nose is corrected and your nasal passage ways are opened up, you won’t struggle to breathe like you did before.

Finding the Right Answers is the First Step

You may be visiting your regular physician every time your nose is giving you trouble. If your doctor’s solutions aren’t working, try visiting a plastic surgeon to discuss what is happening when it comes to your breathing. Your surgeon will evaluate you carefully and make recommendations on the best approach to treat your condition. If medication has already been prescribed without success, functional rhinoplasty could be the answer for you.

Learn More About Rhinoplasty

If you want to learn more about this procedure, make sure you seek guidance from the right surgeon. Dr. Ran Rubinstein is a board-certified plastic surgeon and a rhinoplasty specialist serving Los Angeles and Beverly Hills, CA. Find out if functional rhinoplasty is the answer for you. Dr. Frankel can help you to navigate the ins and outs of health insurance and financing options as well.

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