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Will Health Insurance Cover Rhinoplasty?

by | Dec 21, 2024

Page Tags: 2024 | coverage

Does Health Insurance Pay For a Nose Job?

Nose jobs, officially referred to as rhinoplasty, are among the most common types of plastic surgery. Patients opt for this procedure for a myriad of reasons from improving their face’s symmetry to alleviating breathing troubles. Whether an individual’s health insurance covers the surgery comes down to two factors, including whether it is paid for under their specific health insurance plan and whether the surgery is medically necessary.

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When Does Health Insurance Cover Rhinoplasty?

Health insurance may cover a nose job if the procedure is medically necessary. If the individual does not have full function of their nose due to a deviated septum, a birth deformity, inflammation from chronic allergies, or damage from an accident or injury, the surgery may be considered medically necessary and therefore covered under their health insurance policy. The health insurance company usually requires the individual to undergo nonsurgical treatments for these issues before authorizing payment for the surgery.

ACA-compliant health insurance plans generally cover a large portion of surgical costs for medically necessary rhinoplasty. Each plan is different, however, so before someone schedules their surgery, it is a good idea for them to determine what their cost-sharing responsibility will be.

When Does Health Insurance Not Cover Rhinoplasty?

As is the case with all elective surgeries, rhinoplasty is not covered by health insurance when the procedure is not medically necessary. Cosmetic rhinoplasty changes the overall appearance of the individual’s nose by reshaping it or reducing its size. Commonly, people seek this surgery to create a narrower nose bridge or remove a bump on the bridge, reduce or widen the nostrils, straighten a crooked nose, reshape the tip, or change the angle between the nose and the upper lip.

Cosmetic rhinoplasty can provide a boost to an individual’s confidence and help bring alignment to their facial features. However, while the surgery may correct some psychological problems, it does not address any medical problems. For this reason, patients generally foot the entire bill, which averages $5,483.​

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Partial Coverage for Rhinoplasty

Occasionally, when someone is undergoing rhinoplasty for medical reasons, such as to fix a deviated septum, they may decide to correct a cosmetic problem at the same time. In this case, their health insurance only covers the cost of the portion of the procedure that addresses the medical issue. While it may be hard to predict exactly what insurance will cover and what the patient’s responsibility will be, it may be helpful to request an itemized breakdown of the projected cost of the procedure.

Comprehensive Health Insurance Coverage with Nevada Insurance Enrollment

Even medically necessary surgeries that are covered by health insurance can be a significant expense. At Nevada Insurance Enrollment, our health insurance agents help you review your policy to determine what you should expect to pay for medically necessary rhinoplasty. We can also help you compare health insurance policies across several companies to help you make educated decisions regarding your coverage.

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Out of Pocket Maximum

Your out-of-pocket maximum is the most you’ll have to pay for covered services in a policy period (one year), each January 1st it starts over again, and that includes cost of medications too. After you reach this amount, your health insurance plan will pay 100%.

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Qualifying Life Event

If you experience a major life change, then such a change is often considered a qualifying life event. Such life events affect your existing health insurance coverage and can make you eligible to change your coverage during the special enrollment period.

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Signs You Should Go See Your Doctor

Sometimes, deciding whether to see a doctor is a gray area, but it’s better to err on the side of caution. If you are experiencing a serious injury or illness, it is easy to justify making a call to your local medical office. However, it is important to remember that early detection generally leads to better outcomes.

 

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