AllBodySurgery.com
Will my insurance cover a septo/rhinoplasty?
Im 18 and some time back I went to the ENT doctor and he said to wait until im 18 to have my deviated septum fixed with a septoplasty. Now that im 18 my insurance will cover the septo. But I was wondering if they would cover a rhinoplasty, as I have a bump and excess cartilage on the tip of my nose as a result from that deviated septum im guessing. Insurance papers state.... (this is the deviated septum) Surgery to correct a congenital anomaly – a condition that existed at or from birth and is a significant deviation from the common form or norm. Examples of congenital anomalies are: protruding ear deformities; cleft lip; cleft palate; birth marks; and webbed fingers and toes. (then this is for the rhinoplasty) Cosmetic surgery – any operative procedure or any portion of a procedure performed primarily to improve physical appearance through change in bodily form – unless required for a congenital anomaly or to restore or correct a part of the body that has been altered as a result of accidental injury, disease, or surgery (insurance blue cross blue shield federal employee prgm standard) would a rhinoplasty be covered since it would be nessasary?
Public Comments
- Septoplasty yes, rhinoplasty no.... I had it done in 1995...
- You'd have to schedule a consultation with a plastic surgeon, if the ENT will not be doing the outer portion. The doc will submit a letter of pre-approval stating his case as to why you need this surgery. BCBS will review the info and pictures (if there are pix). Then BCBS will mail a response to you doctor as to what they will cover. The doctor will then call you and give you the portion you are to pay.
- Because of this clause: "unless required for a congenital anomaly or to restore or correct a part of the body that has been altered as a result of accidental injury, disease, or surgery" I would say yes. Most likely you'll need to have your dr get an authorization for the procedures beforehand anyway. When they review the authorization request they'll determine if they consider it to be cosmetic or medically necessary.
- As I understand it, when applying DO NOT use anything mentioning "cosmetic"..If you go to www.cleftadvocate.org they have examples of wording that you should use..Debbie Oliver runs the site and if you have any questions I'd contact her..Good luck to you!
