If you've been suffering from symptoms associated with having a deviated septum, and all the medication you tried to take has been unsuccessful so far, then surgery might be the best option to solve the issue. The procedure itself isn't cheap and the extra fees can add up to a formidable number.
Deviated Septum Insurance: First Things to Look Into
It’s a good option to either look for a medical insurance plan that can ease the costs of the surgery or, if you already have one, to reach out and know how much the company is willing to give to aid you in taking these steps. The typical coverage that an insurance company offers is a copay of the hospital outpatient fees and then a percentage of the whole price of the procedure, usually up to 50%.
Before this happens, the company will have to determine whether this procedure is being done for your health or for cosmetic reasons. To determine this, you will have to talk to your doctor so he can examine the extent of your problems. After you do a series of exams, he will write a letter to the insurance company with all the details of your condition. When the company determines that you need surgery because of health reasons, they will usually shoulder some of the financial burden associated with it.
If for some reason the insurance company determines that the procedure is not being done to relieve you of health problems, there might be complications in getting the funds from them. In this case, more examinations might be required, and additional referrals from your doctor might be needed as well.
Does Insurance Cover Deviated Septum Surgery in the US?
It depends. The reason for having surgery must be directly connected to health issues that you're suffering from, and they need to be properly documented. If this procedure is related to cosmetic improvement, then the insurance company will not pay.
Even if your plan has a pre-approved clause, you should always speak to your doctor, look for referrals, examinations, letters describing your situation, and send them all to your insurance company. This way, you'll be sure if they will or will not cover it, and how much they are willing to put in, instead of doing it first and then trying to justify the need for surgery after it's done and after you've already paid.
There are many rules and stipulations for insurance companies to release funding for different treatments. To qualify for insurance payments, you need to fulfill one or multiple of the following conditions:
Make sure that all of these conditions are properly documented and that your insurance company has copies of them. Once they are verified, getting the benefits should be relatively easy and you can schedule your surgery without any concerns.
What is the Cost of Deviated Septum Surgery with Insurance?
The original costs of the procedure start at $6,000 and, depending on the extent of the intervention, could go up to $30,000 without insurance.
Insurance companies offer on average a $129 copay for outpatient hospital fees and 10% to 50% coverage over the total price, so the whole procedure can cost $4672 (again, on average). These values depend on the quality and coverage of your medical insurance contract, so please direct any specific questions to your own provider, as the values shown here are a national average.
The costs associated with also having a rhinoplasty (traditionally called a "nose job") are not included in these calculations, and they could fluctuate depending on the quality and experience of your doctor, as the skills required for this kind of operation are more unique.
Does Insurance Cover Rhinoplasty for a Deviated Septum?
There are very few situations where rhinoplasty can be covered by medical insurance, as it is largely considered to be a cosmetic kind of intervention. The only ones that can be covered are a deformity caused by a car accident (or similar significant accident) or to treat the damage done by an improperly conducted surgery.
You should know that while correcting a deviated septum can bring some aesthetical improvements to your nose, those changes are minor, as changing the shape of the septum doesn't impact the shape of your nose greatly.
So, if you want to couple the health benefits with the cosmetic ones, your insurance company can still help you with the costs of correcting the nasal septum (up to 50% in some cases) and you can put in the remaining for septoplasty plus a rhinoplasty. Even though the cost might be higher, there is a higher chance that you will be completely satisfied with the procedure and that you don't have to go through two surgeries, with all the risks associated with this scenario.
When looking for a doctor to perform a rhinoplasty coupled with septoplasty, remember to take a look at the doctor's portfolio of patients, and look up some before/after pictures. The skills required to correct a septum are different from the ones required to shape a good-looking nose, and that kind of artistry could also mean an extra in the doctor's fee.
We hope this gave you a good idea of how insurance for a deviated septum surgery works. The bottom line we want you to remember is that different medical insurance plans have diverse rules and restrictions that you will have to navigate, so use this information to reach out to your doctor and insurance provider to get the best possible coverage. Whether you're looking for health benefits or beauty benefits (or a combination of both), there are many available solutions to help you with the costs.