Does Medicare cover Deviated Septum Surgery?

Doctor showing patient bone anatomy of skeleton of nose and nasal cavity on skull. Preparing for rhinoplasty surgery, correcting deviated nasal septum, localization of rhinitis, sinusitis in nose stock photo

By Daniel Petkevich

Nov 18, 2022

Septoplasty and other nasal surgeries might be covered

Difficulty breathing and nosebleeds are just two of the potential health risks caused by a deviated septum. So can Medicare help cover the surgery to straighten your nose? If the surgery is determined to be medically necessary, then yes. Otherwise, Medicare will not offer coverage for cosmetic procedures. 

Stay Up to Date on Medicare!

Header brushstroke decoration.

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

Let's talk more about what goes into this determination. 

What is a deviated septum and what causes it?

A deviated septum is when the thin wall of cartilage that separates the nostrils in your nose shifts to one side. This can lead to an obstruction of airflow and make breathing difficult. It's estimated that 80% of people have some degree of a deviated septum, with severe cases causing difficulty sleeping, headaches, and sinus infections.

The causes of a deviated septum can vary but include congenital issues or trauma such as a broken nose.

Symptoms and diagnosis of a deviated septum

Common symptoms of a deviated septum include difficulty breathing, poor sense of smell, frequent nosebleeds, sinus infections, and snoring. Sometimes the obstructed nasal airway can lead to nasal polyps, benign growths in the sinus that can further impede your breathing.

In order to diagnose the condition properly, your doctor will ask you questions about your medical history and conduct a physical exam that may include a rhinoscopy (an examination using an endoscope that is passed through the nostrils).

Septoplasty

The surgery to correct a deviated septum is known as septoplasty. In this procedure, the doctor will straighten and reposition the septum to improve airflow. The surgery is typically done under general anesthesia in an outpatient setting and may involve other procedures, such as sinus resection or turbinate reduction.

Septoplasty is usually regarded as minor procedure. Most operations take only 30-90 minutes, with recovery lasting for a couple weeks on average. These are among the most common medical procedures performed by ear, nose, and throat doctors. Before your procedure, you might be asked to stop taking certain medications that can increase the risk of bleeding during surgery.

Costs of septoplasty

The cost of septoplasty can vary depending on the complexity of your case, but the cost can range from $6,000 to $30,000.

As mentioned earlier, Medicare will only help to cover the cost if the procedure is deemed medically necessary. But if that is not the case, you still have some options for reducing the cost of your surgery. For example, you can talk to your doctor about financing options and paying in installments.

Medicare coverage for surgery to correct a deviated septum

What does Medicare cover for treating a deviated septum?

For Medicare to offer coverage for any type of surgery, it must be deemed medically-necessary. Medicare Part B may cover the costs associated with a septoplasty if it is deemed to be medically necessary. However, they will not cover cosmetic procedures. In order to determine if you qualify for coverage, your doctor must present documentation of the medical necessity of the procedure. The documentation should include the diagnosis, a description of the procedure, and a plan for post-operative care.

If you meet all of the criteria, Medicare Part B will cover 80% of the costs associated with the septoplasty. You will be responsible for the remaining 20%, although a Medicare Supplement Plan can help cover the remaining 20%.

Takeaway

Deviated septum surgeries are covered by Medicare if they are determined to be medically necessary. If not, there are other ways to cover the costs, such as working with a doctor on financing options. No matter what route you take, it's important to speak with a medical professional about any questions or concerns you have before making major decisions. This content is for informational purposes only. If you have any questions about your Medicare coverage, give us a call today at 1-888-376-2028.

Stay Up to Date on Medicare!

Header brushstroke decoration.

Join the Fair Square Medicare Newsletter to stay informed on cost savings, changes to Medicare, and other valuable healthcare information.

Learn More About Medicare


Birthday stock image

What Is the Medicare Birthday Rule in Nevada?

Mar 28, 2023

Ozempic stock image

Does Medicare Cover Ozempic?

Mar 28, 2023

Pre-Existing condition stock image

Can Medicare Advantage Plans Deny Coverage for Pre-Existing Conditions?

Mar 28, 2023

Cover image

What People Don't Realize About Medicare

Mar 27, 2023

woman in a hospital wearing a bandana being shown information by her doctor stock photo

Medicare Advantage Plans for Disabled People Under 65

Mar 24, 2023

senior couple working in a greenhouse stock image

Medicare Supplement Plans for Low-Income Seniors

Mar 23, 2023

Kansas farm stock photo

Medicare Savings Programs in Kansas

Mar 22, 2023

Cover image

How Much Does a Medicare Coach Cost?

Mar 20, 2023

20 Q's with Fair Square

20 Questions to Ask Your Medicare Agent

Mar 17, 2023

Washington DC stock image

14 Best Ways for Seniors to Stay Active in Washington, D.C.

Mar 11, 2023

Nashville city skyline stock image

14 Best Ways for Seniors to Stay Active in Nashville

Mar 10, 2023

Seattle Public Market stock image

14 Best Ways for Seniors to Stay Active in Seattle

Mar 10, 2023

Union Station in Denver stock image

15 Best Ways for Seniors to Stay Active in Denver

Mar 9, 2023

Indianapolis skyline at night stock image

13 Best Ways for Seniors to Stay Active in Indianapolis

Mar 9, 2023

Charlotte skyline stock image

14 Best Ways to Stay Active in Charlotte

Mar 9, 2023

senior couple doing yoga stock image

13 Best Ways for Seniors to Stay Active in Columbus

Mar 8, 2023

Philadelphia skyline at sunset stock image

13 Best Ways for Seniors to Stay Active in Philadelphia

Mar 7, 2023

Arizona desert stock photo

13 Best Ways for Seniors to Stay Active in Phoenix

Mar 6, 2023

Your Medicare One-Stop-Shop

Your guide to Medicare Parts A & B, Medicare Advantage, and Medigap.

100% free.

Fair Square Medicare

LEGAL

Privacy Policy

MORE


Virgil Insurance Agency, LLC (DBA Fair Square Medicare) and www.fairsquaremedicare.com are privately owned and operated by Help Button Inc. Medicare supplement insurance plans are not connected with or endorsed by the U.S. government or the federal Medicare program. This is a solicitation of insurance. A licensed agent/producer may contact you. Medicare Supplement insurance is available to those age 65 and older enrolled in Medicare Parts A and B and, in some states, to those under age 65 eligible for Medicare due to disability or End-Stage Renal disease. Virgil Insurance Agency is a licensed and certified representative of Medicare Advantage HMO, HMO SNP, PPO, PPO SNP and PFFS organizations and stand-alone PDP prescription drug plans. Each of the organizations we represent has a Medicare contract. Enrollment in any plan depends on contract renewal. The plans we represent do not discriminate on the basis of race, color, national origin, age, disability, or sex. Plan availability varies by region and state. For a complete list of available plans please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), 24 hours a day/7 days a week or consult www.medicare.gov. © 2022 Help Button Inc

We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options.

MULTIPLAN_FairSquareMedicare_01062022_M