Is Functional Rhinoplasty Covered by Insurance in New York?

By: Dr. Sang W. Kim


While many plastic surgery procedures are considered cosmetic by insurance companies because they typically are undergone for solely aesthetic reasons, rhinoplasty is one of the few that can be deemed medically necessary. Colloquially known as a nose job, functional rhinoplasty can be performed for a myriad of medical benefits. So how do you determine whether your rhinoplasty will be covered by insurance?

There is no easy answer to this question. While it mostly depends on the insurance company, our office is happy to provide a list of tips that may prove useful in getting as much help from your insurance as possible.

What Does ‘Medically Necessary’ Mean?

Most insurance companies will state that they only cover procedures and treatments that are considered medically necessary. They will also have a definition of what that entails. Do your research and find out how your procedure could potentially fall under their requirements.

Make sure you have all required documentation and that any necessary exams are performed. This will provide both you and your insurance company proof of any condition that may require a functional rhinoplasty to cure. Patients who suffer from difficulties breathing while sleeping or exercising may qualify for a functional rhinoplasty. This could include conditions such as sleep apnea, snoring, or a blockage in the nasal canal.

Find the Right Surgeon

One of the best ways to ensure your insurance will cover, if not all, at least part of the procedure, is by choosing the right plastic surgeon. Patients will find that having a surgeon who is willing to work with them and their insurance companies makes the whole process much easier.

Our office, led by board-certified plastic surgeon Dr. Sang W. Kim, is always happy to help where we can and are proud to offer our support throughout the whole of your journey.

Get a Second Opinion

The only thing more useful than one doctor’s opinion is two, and it is much harder for an insurance company to dispute a claim with multiple opinions. Having both a qualified surgeon and your family doctor or physician supporting a specific treatment will improve your chances of having the procedure covered.

If you have any more questions about how our office could help you, contact us and schedule your complimentary consultation.

* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.