Is Rhinoplasty Covered By Health Insurance?

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   Marlin McKelvy

   President, Consumer Directed Benefit Solutions, Memphis, Tennessee

   Rhinoplasty is generally nose surgery performed for cosmetic purposes and health insurance does not cover cosmetic surgery (unless it is for restorative purposes such as after an accident or cancer).  That is not to say that rhinoplasty would never be covered but it would have to be for medically necessary purposes.  If you have had chronic health problems caused by your nasal passages it is possible that your insurance carrier will cover this procedure if it is determined to meet the criteria of medical necessity to solve the problem.  Sometimes this can result in some real hair splitting with part of the procedure being deemed medically necessary and part of it cosmetic, resulting in only partial coverage for the procedure by the insurance carrier.  How the doctor codes the procedure can be an important aspect of whether the procedure is approved and how the claim is eventually paid.  Just remember, your insurance company thinks you are beautiful just the way you are.

   Answered on May 14, 2014

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