Will Insurance Pay For Some Of My Rhinoplasty Surgery?

Q: Dr. Eppley, How much will a rhinoplasty surgery cost me? I have Aetna Insurance and I want to know how much they might cover. By the way I have breathing issues and I went to a doctor and he told me my septum needs correction and my insurance might cover half of the whole surgery price.

A: Let me provide you with some clarification on your nose surgery and a better understanding about the costs of such surgery. The concept the ‘insurance may pay half of the whole cost of the procedure’ is both misinformed and overly simplistic.

What you are seeking is a nose procedure known as a septorhinoplasty. This is a procedure that combines the correction of a functional problem (septum and turbinates) and an aesthetic nasal issue. (rhinoplasty) While they are commonly done together and one does affect the other one, they are viewed economically as two separate issues no matter where you are having the procedure performed. The septum and turbinates are functional airway issues and are often covered by insurance. The rhinoplasty is an aesthetic issue and is never covered by insurance for common aesthetic reasons. Just because the two procedures are done together does not in any way mean that insurance is covering any cost of the rhinoplasty. Those fees must be paid out of pocket and in advance and includes the surgeon’s fee and the operating room and anesthesiologist’s time to do it. When done together a surgeon may choose to lower their professional fee for the rhinoplasty as a courtesy although they are under no obligation to do so.

Thus the only thing that insurance covers has nothing to do with the rhinoplasty. And if you do not do careful financial analysis beforehand (how much is your deductible, what is your percentage of costs beyond a certain dollar amount of what insurance pays), you could easily end up paying more for the whole procedure using insurance than if you paid the entire septorhinoplasty as a complete cosmetic procedure.

Dr. Barry Eppley

Indianapolis, Indiana