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Friday, September 5, 2014

Is Rhinoplasty covered by insurance in the U.S., U.K. and Canada?

By Kelly Brown

Rhinoplasty – also known as a nose job – is becoming an increasingly popular cosmetic surgery throughout the Western world. With more people interested in the procedure than ever before, it’s no surprise that the idea of getting it covered by insurance has been considered, and attempted, on more than one occasion. Unfortunately cosmetic surgery is rarely covered by standard health insurance plans, but coverage can vary depending on where you live.

Cosmetic surgery insurance coverage
Function vs appearance related surgery is not considered cosmetic by insurers

Canada


Provincial health care in Canada will only cover necessary medical procedures. Any elective procedures, including cosmetic surgery, will not be covered under provincial medical insurance. But not all forms of rhinoplasty are strictly cosmetic procedures and, in cases where this treatment is deemed medically necessary, provincial insurance carriers will often cover the expenses. This can occur in cases of:
  • Damage to the nose caused by injury, previously required surgery, or developmental reasons;
  • Breathing problems caused by a deviated septum or other surgically treatable condition; and
  • Broken noses resulting in a crooked appearance.
Even if you are able to get your rhinoplasty treatment covered because of a medical condition, it’s unlikely that you will end up with your exact desired results. You will need to pay out-of-pocket in order to combine your medical procedure with a cosmetic one. This is because the changes made to the nose in order to correct breathing problems or a deviated septum occur inside of the nose and do not affect its outward appearance. By combining procedures, you may be able to save some money on general surgical costs and the anesthesia required for both procedures.

United States


In the United States, most health insurance plans will have similar rules to the provincial health care providers in Canada: Anything related to improving the function of the nose is likely to be covered, while elective or cosmetic procedures won’t be. Even if you are seeking medical treatment to improve nasal breathing or repair structural damage from a nose injury, it’s always best to obtain pre-authorization from your insurance carrier. This will prevent surprises down the road in case your carrier decides not to cover certain procedures. Regardless of your surgeon’s opinion, the insurance companies may not choose to cover your treatment.

While it is possible to combine procedures in the United States as well, it’s important for patients to be aware that they will be financially responsible for all associated costs from supplies used and anesthesia given, as well as surgeon fees and facility costs. These fees may be discounted when combined but patients will still be responsible for deductibles and copays triggered by their health plan.

United Kingdom


Most insurance companies simply cannot afford to offer blanket coverage for cosmetic procedures as, if abused, it could bankrupt them.  As in Canada and the United States, procedures will typically have to be medically required coverage in order to abide by standard health insurance providers, but there is some leeway for getting cosmetic  surgery procedures approved through the NHS.

In the last decade, over 8000 tummy tucks have cost the NHS over 50 million pounds. Largely offered to obese patients, abdominoplasty procedures have been claimed by numerous mothers seeking to reclaim their pre-pregnancy bodies. The coverage is intended to be restricted to those with clinical need but in some cases “psychological need” has been cited and the procedures awarded. 



About the author: I am Kelly Brown, a medical student who is fanatical about exploring new ideas in the health industry. It has been my greatest dream and a wish made over the shooting star to be a doctor someday and I can’t explain my joy as I am getting closer to achieving my goal. I love the way plastic surgery transforms a person into something that he/she has been wishing to be like. I have a long way to go in getting hold of the subject in a more profound context. You can follow me at google plus

Image license: License: Royalty Free or iStock source: shutterstock.com

2 comments:

  1. Definitely, cosmetic surgery is rarely covered by health insurance plans, and it the same time it’s very expensive. So there must be a way to cover the costs. Patients might consider loans for the unexpected needs which might be helpful indeed. They were specially designed for similar cases and taking into consideration their moderate rates, they might be the solution to the problem.

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  2. I definately would not suggest taking an instant loan in uk to cover your surgery expences. If you can not afford a surgery now, you better start saving or, another option, find a surgery company who also offers low cost unsecured loans, but make sure you read the terms.

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