subject: When Is Rhinoplasty Medically Necessary? [print this page] Trying to get your health insurance to pay for rhinoplasty is an uphill battle. Septoplasty, corrective surgery to straighten out the nasal septum, is different and can often be covered by medical insurance. However there are exceptions to every rule, and it is no different when it comes to plastic surgery. When it is medically necessary to make a cosmetic change to the nose, you can be sure that a patient must be able to show the necessity to the insurance company with the help of a doctor and a cosmetic surgeon.
To Correct a Nasal Deformity
Sometimes a patient with a cleft lip or a cleft palate will also need a rhinoplasty to complete the transformation. While this operation is mainly to ensure that the nose and surrounding area looks good, it has value in that it can make common tasks that most people take for granted easier. Before the operation can take place, a patient must receive approval from a doctor. From there, certain documentation will be required to get the case considered an exception for the coverage.
The doctor will need to write a letter and fill out paperwork demonstrating that the patient needs the rhinoplasty. Along with any documents, photos are usually required. These photos must show the deformity from several different angles. If any type of imaging has been done, copies of these pictures should also be included.
To Correct a Nasal Obstruction
If you have ever struggled to breathe through your nose, you understand that panicked feeling. While a septoplasty is the traditional solution, sometimes a rhinoplasty is necessary. When there is an obstruction that has nothing to do with the septal nasal airway, a doctor may need to go in and make sure that the internal valves of the nose remain open.
Proving that this procedure is medically necessary also requires extensive documentation. Medical records must be produced that show a prolonged issue with the nasal blockage. In some cases, a patient must prove that other attempts have been made to remedy the problem but only this cosmetic surgery will be sufficient to solve the problem.
Individual Case Reviews
If a rhinoplasty is medically necessary, it is important to begin the process of asking the health insurance to cover the procedure as soon as possible. It could take weeks, months or in some cases years before the issue is resolved. Before submitting anything, make sure that all of the paperwork is in order. Any type of medical reports that deal with the nose need to be included. Be sure to keep copies of everything, as you may need to show the same documentation multiple times throughout the process.
