Does Medicare Cover Deviated Septum Surgery

A deviated septum can lead to problems like breathing difficulties and nosebleeds.

Wondering if Medicare can assist with corrective surgery? Yes, if it’s deemed medically necessary.

Otherwise, Medicare won’t cover cosmetic procedures.

Deviated Septum Surgery
Deviated Septum Surgery: Photo surgery (Reddit)

What is a deviated septum and what causes it?

Deviated septum occurs when the nasal cartilage shifts, obstructing airflow and causing breathing problems.
About 80% of people have some degree of deviation, with severe cases leading to sleep issues, headaches, and sinus infections.
Causes include congenital factors and trauma like a broken nose.

Symptoms and diagnosis of a deviated septum

Deviated septum symptoms: breathing issues, reduced smell, nosebleeds, sinus infections, snoring, and potential nasal polyps.
Diagnosis involves a medical history review and a physical exam, which may include rhinoscopy with an endoscope.

Septoplasty

Septoplasty corrects a deviated septum, improving airflow. It’s a minor procedure, often done in an outpatient setting under general anesthesia.
It may include other treatments like sinus resection or turbinate reduction.
Typically lasting 30-90 minutes, recovery takes a few weeks. Ear, nose, and throat doctors commonly perform this surgery.
You may need to stop specific medications before the procedure to reduce bleeding risk.

Costs of septoplasty

Septoplasty costs range from $6,000 to $30,000, varying with case complexity.
Health insurance covers it if medically necessary; otherwise, explore financing options with your doctor to manage expenses.

Medicare coverage for surgery to correct a deviated septum

Medicare covers septoplasty if medically necessary, not cosmetic.
Healthcare coverage Part B may cover it, but your doctor must provide documentation of medical necessity, including diagnosis and post-op care plan.
If eligible, Medicare covers 80%, and a Medicare Supplement Plan can help with the remaining 20%.

Conclusion

Medicare covers medically necessary septoplasty; otherwise, explore financing options with your doctor.
Always consult a medical professional before making major decisions.
Informational purposes only.

Leave a Comment