How to get insurance to pay for rhinoplasty?
A surgery was performed on the deviated septum a couple of years ago - turns out I STILL can't breath. And how will I go about getting coverage for a rhinoplasty.
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- I have not found any insurance that will cover rhinoplasty, but there are companies that will finance a rhinoplasty so that you could pay for it over several years.
- ~~If your doctor writes a request detailing the medical necessity (has to be clear it is not for cosmetic purposes) then you will get an authorization for coverage.~~
- Read your policy. Some companies will not cover rhinoplasty for any reason. If this is the case, you are out of luck unless you change insurance companies. If your policy covers the procedure, you need a letter of medical necessity - one that's really well-written and persuasive.
- Most insurance plans specifically exclude rhinoplasty, however septoplasty may be covered. First, contact your insurance company and determine if the plan has the option of covering the procedure when medically necessary. If it is covered, ask for a copy of the coverage position, to determine what criteria need to be met to obtain approval for the procedure. Some companies put the criteria online. I know that CIGNA Healthcare and Some Blue Cross plans have their coverage positions posted on their websites. Go to the website and do a search for coverage position. Then find the coverage position for rhinoplasty. This will advise what information will be required to review for medical necessity. At that time, you will want to have your physician compile all of the information and submit for either an authorization (if your plan requires a pre-certification) or pre-determination, if no authorization is required. This will determine if you meet criteria when the procedure is covered.
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