Will My Health Insurance Pay For My Rhinoplasty?

Q: I have a large bump on my nose and a long pointy nose to boot. My girlfriend tells me it looks ‘birdlike’. I also have trouble breathing through the right side of my nose. Can you help me get my health insurance to pay for my nose surgery?

A: Nose surgery can be divided into two areas, internal and external. Internal nasal surgery, often called septoplasty, is done to try and improve one’s breathing through the nose. This usually involves straightening of a crooked septum (septoplasty) and reduction of the size of the inferior turbinate bones. (turbinectomy) External nasal surgery, known as rhinoplasty, is done to change the shape of the visible external nose. When internal and external nasal surgery is done together, which is common, is called septorhinoplasty.

Internal nasal surgery is almost always covered by health insurance because its purpose is to improve a medical function, breathing through the nose. External or rhinoplasty surgery is not covered by insurance because it is changing appearance which is a cosmetic objective…unless the shape of the nose is the result of a traumatic injury, a birth defect (such as cleft lip and palate) or from removal of cancer.

Many patients are under the false belief that they can get their rhinoplasty covered by insurance because they have trouble breathing through their nose. While the breathing part may be covered, the rhinoplasty portion is the responsibility of the patient.  The costs of that portion of the nose operation is given to patients in advance of the surgery date as it has to be paid prior to surgery being performed.

Dr. Barry Eppley

Indianapolis, Indiana

Dr. Barry L. Eppley
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Board Certified Plastic Surgeon