Does blue cross blue shield cover rhinoplasty

Most patients often wonder if their health insurance will cover the cost of a nose job. The answer to that question depends on two variables focused on the patient's insurance provider and the type of rhinoplasty procedure they need. If your main goal is to change the exterior shape of the nose for cosmetic reasons, also known as cosmetic rhinoplasty, it is typically not covered by insurance. However, if the interior passages of the nose need altering to improve breathing or correct a deviated septum, also known as functional rhinoplasty, then insurance may cover the cost of the procedure. In some cases, men and women even consider a nose job to address a functional issue, but also have cosmetic matters they would like to address at the same time. At Contoura Facial Plastic Surgery, we do not accept insurance for rhinoplasty procedures, medical or cosmetic.

Whether a medical need or solely for aesthetic reasons, individuals considering rhinoplasty should have an open discussion with a plastic surgeon like Dr. Robert Garcia to get answers. Both men and women in the Jacksonville area considering a nose job can turn to double board-certified facial plastic surgeon Dr. Garcia and his team at Contoura Facial Plastic Surgery located in Ponte Vedra Beach, FL.

What is the difference between a cosmetic and a medical nose job?

Rhinoplasty is one of the top five most popular cosmetic procedures performed every year in the United States. For some Jacksonville men and women, a nose job is purely for cosmetic reasons to improve their profile and help them feel more confident about how they look. However, some individuals have a medical need for their rhinoplasty surgery. The primary difference between a cosmetic and functional rhinoplasty is whether a person has full function of their nose prior to the procedure. Patients struggling to breathe properly due to a deviated septum or damage to their nose due to an accident or injury have a medical need for their nose job procedure. Read on for a further breakdown of both types and how insurance coverage is dependent on why a patient may need this type of plastic surgery.

What are the cosmetic reasons for rhinoplasty?

Cosmetic rhinoplasty can help change the shape, size, and overall appearance of a person's nose. The nose is one of the most predominant features of a person's face. When a person feels their nose is disproportionate or distracts from their other facial features, consideration of a nose reshaping or rhinoplasty procedure goes to the top of the list. Some common cosmetic requests for a nose job are:

· Narrow the nose bridge

· Remove a bump on the nose bridge

· Narrow or widen the nostrils

· Reshape the nose tip

· Straight a crooked nose

· Alter the angle between the nose and upper lip

What are the medical reasons for rhinoplasty?

In some cases, individuals suffer from a deformity in their nasal passageway that is significant enough to obstruct the airway. A functional or medical rhinoplasty procedure can alleviate or permanently eliminate this problem. Common medical reasons for a nose job are:

· Deviated septum

· Birth deformity or a cleft palate

· Trauma or injury to the nose

· Nasal inflammation due to chronic allergies

How do I find out if my nose job is covered by insurance?

In general, cosmetic rhinoplasty procedures are considered elective surgery and not covered by health insurance. If there is a functional or medical component, such as a problem with breathing or other cause, then that portion of the procedure may possibly be covered by a person's insurance plan. Most insurance providers typically reimburse patients for the cost of a rhinoplasty procedure if it corrects or improves breathing due to structural damage or a deformity. All insurance providers have medical criteria and parameters to determine a patient's medical coverage for surgical procedures. If patients are unsure what type of rhinoplasty procedure they need, then starting the process of consulting with a double board-certified facial plastic surgeon, like Dr. Garcia, is the first step.

A rhinoplasty procedure can tackle a myriad of problems from straightening the profile of the nose, correcting asymmetry, improving the shape, reducing the volume of the nose, and enhancing the airways for better breathing. Rhinoplasty procedures overall make individuals feel better about how they look, and finding out if your insurance plan will cover it is part of the process. Dr. Garcia will listen to your concerns, evaluate what you need, and answer any questions during a private one-on-one consultation. If you are contemplating a rhinoplasty procedure, we invite you to call Contoura Facial Plastic Surgery in Ponte Vedra Beach, FL and let our experienced staff help you every step of the way.

The cost of a rhinoplasty surgery can be a deterrent, however, as it’s not an inexpensive procedure. Unfortunately, most insurance companies don’t cover surgeries that are purely cosmetic. But did you know that nose jobs are not just for cosmetic enhancement? They can also improve a person’s ability to breathe freely through the nose. And the good news is that when rhinoplasty is used for medical purposes, it can often be covered by insurance. 

How to get rhinoplasty covered by insurance

In order to get your nose job covered by insurance, you’ll have to prove it’s needed to address functional problems that have not responded to more conservative corrections. Rhinoplasty may be deemed medically necessary, and therefore covered by insurance, if you have difficulty breathing due to: 

• Nasal fracture
• Deviated septum
• Cleft palate
• Cleft lip
• Polyps
• Structural abnormalities 
• Chronic nasal or sinus inflammation
• Misshapen cartilage

Functional and cosmetic rhinoplasty is often done in combination, altering both the interior passages and the exterior shape and contours. Cosmetic rhinoplasty can be used to enhance facial harmony by correcting:

• Nostrils that are too wide or too narrow
• Visible humps or depressions in the bridge
• Deformed nasal tip (enlarged or hooked, for example)
• Nasal asymmetry

When combining functional and cosmetic rhinoplasty, insurance typically only covers the functional portion of the procedure. 

During your nose job consultation at Feel Beautiful, Dr. Laverson will perform a thorough physical examination and evaluate your breathing history in order to determine whether your nasal passages are functioning properly. It’s important that you provide him with as much information as you can about any trauma or conditions that may be the cause of your breathing problems, if you have any. If Dr. Laverson finds that your breathing function will be improved by a nose job, a pre-authorization letter can be sent to your insurance company to determine the estimate of your benefits. 

The most beautiful nose depends on the most skilled and experienced surgeon

Whether you’re looking to enhance your facial aesthetics or improve your ability to breathe easily and efficiently through your nose, you’re in the right place. Dr. Laverson specializes in rhinoplasty procedures and has performed countless nose jobs, both functional and cosmetic.  He is well-known for his skill, precision, and artistry, as well as his compassion and open communication. As always, Dr. Laverson and the rest of our staff at Feel Beautiful are committed to helping you look and feel your absolute best. For more information on the different types of rhinoplasty procedures, or to schedule your consultation with Dr. Laverson, give us a call at (858) 295-4001 today.