How to Get Insurance to Cover a Nose Job
Factors to Consider
- Whether the procedure is medically necessary or considered cosmetic
- The surgeon’s experience
- The type of nose job and its complexity, i.e. Open vs Closed Rhinoplasty
- The extent of a nose job
- Your individual insurance plan
Insurance is a great way to help with the cost of a nose job, otherwise known as rhinoplasty. To make sure that your insurance adequately covers a nose job, there are several things to consider.
Medical Necessity:
The most important factor for insurance to cover a nose job is whether or not the procedure is deemed medically necessary. Insurance companies only cover procedures that are deemed medically required due to health reasons. If it is for cosmetic reasons, generally, you will need to pay for the procedure out of pocket. Mentioned below are some examples of medically-necessary nose jobs that can be covered.
- Correction of a deviated septum causing difficulty in breathing
- Congenital defects that prevent breathing
- Reconstruction due to injuries such as fractured nose
Surgeon’s Experience and Skills:
The surgeon’s level of experience and skills can also make a difference when it comes to insurance coverage. Generally, insurance companies preselect their health care providers, hospitals, and doctors. The goal is to ensure satisfactory care for the patient. It is important to check with your insurance provider if the surgeon is included in their network and if the procedure is covered.
Type and Complexity:
In addition to surgeon’s experience and need for a nose job, there are types of nose jobs to consider as well. An open rhinoplasty involves more complexity and time as it requires cutting the skin between the nostrils to gain access to the nose structure. Closed rhinoplasty requires less time and involves making incisions internally that aren’t visible.
Extent of Nose Job:
The extent of a nose job is another important factor in determining the amount of coverage that insurance will provide. If you’re looking to have a few minor changes to your nose, most insurance companies are likely to cover them. However, more complex operations may be considered cosmetic and deemed unnecessary for insurance to cover.
Individual Insurance Plan:
Lastly, it is important to remember that even if all the other factors are met, the amount of coverage conferred by your individual insurance plan will be determined by them. Make sure to call your insurance company and ask about the coverage limits and any other details that might affect your coverage.
Overall, if you want to get your insurance to cover your nose job, you should understand if the procedure is medically necessary, the surgeon’s experience, the type, complexity and extent of the procedure, as well as the terms of your individual insurance plan. Additionally, it is important to double check your insurance plan by calling your provider and asking what is covered.