Question: When you perform a combined deviated septum surgery with a nose job, how does insurance coverage work? Do they pay the whole thing or a portion of it? If just a portion, how do you separate out what gets paid and what doesn’t?
Answer: We get this question about insurance and septoplasty and rhinoplasty a lot and we have many patients that require both functional septoplasty as well as cosmetic Rhinoplasty.
For all practical purposes these two procedures are kept separate and billed separately although they can both be done at the same time/session. For example if you had a skin cancer removed as well as got breast augmentation then in the same surgical session both could be done by your plastic surgeon (not me since I do not do Breast Augmentation) but both can be done while you are under anesthesia and the breast implants would be cosmetic and the skin cancer removal would be through insurance. For the nose, insurance would hopefully cover the septoplasty although some insurance do refuse even that. If insurance paid for the septoplasty then it would cover the surgeon’s fee as well as part of the hospital fees and part of the anesthesia fee. However, for most facial plastic surgeons, the cosmetic fee for the rhinoplasty is much higher than the fee for the septoplasty so in effect you end up saving a little bit of money when it’s all said and done compared to paying for the entire thing yourself out of pocket. If your insurance deductable is very high then you may actually be better off paying for everything out of pocket much like a situation where a driver may choose to pay for a minor car collision themselves if their auto insurance deductable is too high.
There are some general ENT surgeons who will primarily charge your insurance and charge you just a tad more for the rhinoplasty but that is because their cosmetic rates are much lower than a facial plastic surgeon who is known for their cosmetic work and skill and training.