Obtaining Insurance Coverage for Your Rhinoplasty
A substantial number of people have shown apprehension in undergoing a rhinoplasty procedure thanks to the exorbitant costs often associated with the procedure. The unfortunate fact is that few people actually conduct research into the ways one can offset the cost of this surgery. Although you may have heard some disparage this claim, insurance companies will extend coverage to policy holders for a rhinoplasty surgery. This of course is on a case-by-case basis. Coverage may also be partially granted depending on the circumstances.
Individuals aspiring to receive this procedure for mere aesthetic purposes have little hope in obtaining coverage. Insurance companies will deny coverage for a surgery that is merely elective. Any variables that render the treatment a medical necessity in your particular circumstances are grounds for full or partial coverage.
Those hoping to receive the procedure to enhance the functionality of their nose may be covered. The patient him or herself, however, will not be reporting directly to the insurance company. Rather, their doctor will need to speak with the carrier to inform them of the patient's circumstances. Paperwork will likely be involved, however, it will be completed by your physician. Once everything is submitted for review, it will be up to the insurance company to either approve or deny the claim.
Most insurance companies will agree to piggyback at least some of the cost of your rhinoplasty if you have evidenced that it will be able to improve your health. Individuals who were born with a nasal deformity or sustained some injury that hindered the functionality of their nose stand the best chances in obtaining coverage from their insurance provider. In such circumstances, the procedure is no longer considered cosmetic but rather reconstructive. You will have to wait an extended period of time before you hear back from your insurance company. As such, start dealing with the insurance aspect well before you intend to receive the procedure.
Typical problems found amongst those planning to receive a rhinoplasty for medical reasons include breathing issues, as well as persistent (and at times pulsating) headaches. A common misconception is that a rhinoplasty surgery can correct a deviated septum. This is not the case. A septoplasty is performed to correct a deviated septum. The predominant characteristic that sets these two apart is that one is considered elective, while the other a medical necessity. Nose deformities that cause breathing problems and the like can contribute to the development of other conditions, placing the patient in danger and discomfort. Hence, these patients are very eligible for coverage.
Although those who request coverage often try to make a convincing argument for their cause, sometimes insurance companies outright deny their claim. Just because you receive a denial letter in the mail does not mean it is the end of the road. You can pursue your rhinoplasty procedure by filing an appeal with the insurance company.
Protocols for going about this can widely vary, hence, you should conduct the needed research. Try to get as familiarized as possible with your insurance policy and thereafter correspond with the correct parties to pursue an appeal. Be ready to provide your carrier with additional documentation if requested.
Be sure to have any pertinent material on-hand to forward to your insurance company. Don't be lazy, as it is really not in your best interest to piggyback the cost of the procedure. The entire process can be time consuming, however, in the end it can be equally as rewarding.
May 14 2009 | Rhinoplasty | No Comments »