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Rhinoplasty Insurance Coverage: What You Should Know
When patients pursue cosmetic surgery for their nose, one of their first questions is, “Does insurance cover rhinoplasty?”
Unfortunately, the answer is rarely as straightforward as you might hope.
In most cases, coverage depends on your insurance policy and whether any part of the surgery is considered “medically necessary.”
To help provide a little more clarity, here’s a general overview of how rhinoplasty insurance coverage works — and a few things to keep in mind as you navigate the insurance process.
Is Rhinoplasty Ever Covered by Insurance?
The good news is that rhinoplasty can be covered by insurance. However, most insurance companies will only cover cosmetic procedures if they’re performed to correct functional problems. (In other words, insurance will likely not provide coverage if you’re pursuing surgery for purely cosmetic reasons.)
Medically necessary functional concerns usually include:
- Breathing issues caused by abnormalities, such as a deviated septum
- Nasal obstruction related to trauma or a congenital malformation
- Structural defects caused by injury, severe infection, or cancer
“If a patient’s breathing is impaired by a structural issue, like a deviated septum or nasal valve collapse, insurance will often cover the functional repair,” says Dr. Arjuna Kuperan, fellowship-trained nose and sinus surgeon at My Houston Surgeons. “However, any cosmetic adjustments made during the same procedure are typically not covered.”
It’s also important to note that these conditions can be corrected through septoplasty, turbinate reduction, nasal valve repair, or another functional nasal procedure. So, while you might opt to combine your cosmetic rhinoplasty with your medically necessary procedure, most insurance providers will only cover the functional portion of the surgery.
Conditions That May Qualify for Covered Rhinoplasty
Many patients come to us wondering how to get rhinoplasty covered by insurance. However, because cosmetic rhinoplasty is considered an elective procedure, it probably will not qualify for coverage on its own. That said, if you have a nasal condition and choose a board-certified plastic surgeon who can address structural and cosmetic needs in one procedure, you’re likely eligible for at least partial coverage.
Conditions that often qualify for coverage include:
- Deviated septum
When the wall of cartilage separating your nostrils is crooked, it can restrict airflow through at least one nostril and lead to chronic congestion, sinus infections, and snoring.
- Nasal valve collapse
If your nasal valve (the narrow part of your nasal airway) becomes weakened or collapses, it can severely limit nasal breathing and cause persistent congestion.
- Nasal trauma
A broken nose or defect that develops after trauma can obstruct airflow and impair overall nasal function.
- Congenital anomalies
Some people are born with malformed nasal structures that make breathing difficult and increase their risk of developing other conditions, like sleep apnea.
- Post-surgical reconstruction
Surgeries to remove tumors or infected tissue may leave patients with cosmetic and functional issues that require reconstructive nose surgery.
Septoplasty vs. Rhinoplasty: What’s the Difference?
Many people living with breathing impairments (like a deviated septum) also want to refine the appearance of their nose and may be uncertain whether they should pursue a septoplasty or a rhinoplasty.
Here’s how they differ:
- Septoplasty
A septoplasty corrects irregularities of the septum by reshaping or removing parts of the septum that limit your airflow. Most people choose this procedure if they’re having trouble breathing through one or both nostrils, have frequent sinus infections, or struggle with snoring and breathing-related sleep disturbances. - Rhinoplasty
A rhinoplasty enhances the nose appearance and improves facial balance by adjusting nostril size, reducing humps, correcting dips, or reshaping the tip. Patients typically elect to undergo this procedure when they’re unhappy with the aesthetics of their nose.
Fortunately, you don’t have to choose between correcting structural and aesthetic concerns. Patients who want to address their nose’s appearance and deviated septum may be interested in a combined rhinoplasty and septoplasty (often called a septorhinoplasty).
Can I Combine Cosmetic and Functional Rhinoplasty?
Many patients opt for rhinoplasty alongside a medically necessary procedure to avoid undergoing two surgeries (and facing two separate recoveries), and surgeons often recommend combining procedures so they can ensure cosmetic and functional improvements work harmoniously.
In addition to septorhinoplasties, combined surgeries are also available for patients who need functional reconstruction, valve repair, or other structural corrections and want to refine their nose shape and symmetry. (This kind of combined surgery is sometimes called a functional rhinoplasty.)
“We often recommend combining cosmetic and functional procedures when possible,” says Dr. Kuperan. “Not only does it streamline recovery, but it also ensures the internal structures and external appearance of the nose are in harmony.”
However, remember that when it comes to insurance for nose surgery, you will likely have to pay out-of-pocket for any cosmetic portions of your combined procedures.
How My Houston Surgeons Can Help With Insurance-Based Rhinoplasty
One of the most important things you can do when exploring any cosmetic or medically necessary procedure is to choose a board-certified surgeon with proven expertise in treating patients with similar needs and conditions.
Our Houston surgeons have extensive knowledge, training, and experience in performing cosmetic rhinoplasties and correcting complex functional concerns. Our care team can also help you navigate nasal valve, reconstructive, or deviated septum surgery insurance coverage to help reduce out-of-pocket expenses.
If you’re curious about your options for improving your breathing concerns, your nose’s appearance, or a combination of both, schedule a rhinoplasty consultation in Houston with one of our leading providers. Improved comfort and confidence are just a step away.