Rhinoplasty And Insurance Coverage
Because a rhinoplasty can be medically necessary
, there are steps to take to find out whether or not it will be covered by medical insurance. If not, you will need to decide if you want to proceed and pay out of pocket for the procedure or whether or not you want to give up on the idea completely. There are several different parties that will work together to determine whether or not this is covered by insurance.Your Responsibility
It is in your best interest to make sure that you are at the center of everything that takes place when it comes to rhinoplasty and your medical insurance. You want to be the person documenting everything, hanging on to copies of paperwork and even making the phone calls to follow up with everyone else involved. From the time you decide to pursue this, begin to keep everything from receipts for your office visits, prescriptions, and even phone conversations that you have.
When you are documenting a phone call, be sure to include the date, time, who you spoke to and what was said. If you are making calls to an insurance company, it may be that you speak to someone new in customer service every time that you call in the beginning. It will help to know what you have been told and the person who said it. When you speak with your physician, be sure to take notes. You want to make sure that you are clearly understanding what he is saying in regards to the rhinoplasty and whether or not it is medically necessary.
Your Doctor
Your doctor will be the main person that determines whether or not the rhinoplasty is medically necessary or beneficial to you. You will need this information in writing and make sure that it gets to the insurance company. While this is still not a guarantee that everything will be taken care of and paid for, it does get you headed in the right direction. If you have been making frequent visits to the doctor for various nasal and sinus issues, this will be part of the information that he considers when making his decision.
Your Insurance Company
At first, it may be that you talk to several customer service representatives until things are settled and the actual rhinoplasty is approved. Look through all of the paperwork that you received at open enrollment to see if this type of procedure is included. If not, you can call and see what they will need to cover some or all of the operation. They may give you a list of papers or documentation that will show the medical need.
Remember that there are three outcomes: insurance can not cover any of the cost, it can cover some of the cost, or insurance can cover all of the cost. Think about what each of these results means for you and what you will do in the case of each one. Be prepared no matter what happens.
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