Deviated Septum Covered by Insurance

Is A Deviated Septum Covered By Insurance?


01 Aug 2022 | 0 | by kjh

2560170login-checkIs A Deviated Septum Covered By Insurance?

You may have friends who say they had a deviated septum so they needed plastic surgery.  But then you wonder to yourself, “maybe they’re just saying that and really just had a cosmetic procedure.”  Well, actually it’s not that easy in terms of insurance coverage. There are two types of plastic surgery for the nose: reconstructive surgery which restores the form and functions of the nose and cosmetic surgery which changes the appearance of the nose.

And what is a deviated septum?  According to UCI Health, the nasal septum is a structure in the middle of the nose composed of cartilage and bone. It is lined on both sides by the nasal mucous membrane. The septum completely separates the right and left nasal cavities, and the front-most portion of the cartilage has a role in external nasal structure and support.

Nasal septal deviations, or areas of crookedness, are common and may cause nasal obstruction or blockage. These deviations may be from traumatic facial injuries or congenital, meaning they are present at birth. Sinusitis may develop if the septum is deviated in an area blocking the sinus drainage pathways. Medications usually have limited benefit because they cannot address the anatomic problem. Surgery helps straighten the septum to improve airflow; this surgery is termed septoplasty.

If you want to have surgery for a deviated septum, your insurance company might pay for a portion of it.  But straightaway the insurance company will want to determine whether the procedure is being done for cosmetic reasons or for your health.  So chances are if you have friends who had cosmetic surgery, they paid for it themselves.

The typical coverage that an insurance company offers is a copay of the hospital outpatient fees and then a percentage of the full price of the procedure, usually up to 50%. A series of exams are most often required by your doctor with a written letter to the insurance company with all the details of your condition. Work closely with your doctor since most doctors are experienced in terms of what the insurance companies need for coverage.



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