When Is Rhinoplasty Covered by Insurance?

cosmetic surgery

As you might expect, the majority of cosmetic procedures available to improve the way you look will not be covered by insurance.

This usually means you will have to pay for the work out of your own pocket if you want to have a so-called nose job, formally known as rhinoplasty, for instance.

In general terms, the stock answer to the question of whether your insurance company will pay for rhinoplasty procedures is no because it is considered as elective surgery and, therefore, not covered by health insurance.

There are potential exceptions to the rule. Here is an overview of potential scenarios where an insurance company might accept your claim and pay for surgery.

Cosmetic or medical reasons

Some people are simply not happy with the way their nose looks and they might want to have rhinoplasty so that their nose can be reshaped or maybe to remove a bump on the bridge or their nose, for instance.

Whether you want to straighten your nose or maybe widen or narrow your nostrils, these are some prime examples of what would be classed as cosmetic reasons.

You might also be put forward for surgery if you have a valid medical reason for having rhinoplasty procedures.

It is possible that you suffered some sort of birth deformity such as a cleft palate, or you could have suffered a trauma or injury that has had an impact on the look and functionality of your nose.

If you are experiencing breathing difficulties as a result of problems with your nose, for example, this might be considered as a medical component in your insurance claim and it is possible that they might agree to fund part or all of the work needed.

Check the terms and conditions

There are no hard and fast rules that apply across all insurance providers so you have to check the terms and conditions of your health insurance policy to see what their particular interpretation of medical reasons happens to be.

As a general guide, the majority of insurance providers tend to agree to pay for rhinoplasty if it is demonstrated that the procedure will improve the patient’s ability to breathe normally or corrects structural damage that has occurred.

What you might discover is that the insurance provider might agree to cover the portion of the procedure that is specifically defined as a medical or functional component of the proposed work.

The first step

The first part of the process is to seek a professional opinion from a plastic surgeon who can guide you as to what sort of rhinoplasty procedure is required to fix your particular problem.

If the work is necessary for improving your airways and helping you to breathe properly that might be covered by insurance. However, if the work is to improve your appearance it is far less likely that your health insurer will meet a claim for surgery.

It might be that the insurance company will part-fund the work. Once you know what needs to be done you can approach your insurer and see whether they believe you have a valid claim for having a rhinoplasty procedure funded.

Photo by engin akyurt on Unsplash

Mandy Kloppers
Author: Mandy Kloppers

Mandy is a qualified therapist who treats depression, anxiety, OCD, PTSD, trauma, and many other types of mental health issues. She provides online therapy around the world for those needing support and also provides relationship counselling.

Mandy Kloppers

Mandy is a qualified therapist who treats depression, anxiety, OCD, PTSD, trauma, and many other types of mental health issues. She provides online therapy around the world for those needing support and also provides relationship counselling.

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