Talk of The Villages Florida - View Single Post - Traditional Medicare to require prior authorization for some procedures
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Kelevision Kelevision is offline
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Quote:
Originally Posted by OrangeBlossomBaby View Post
"Can be" and "are" are different things though.

If you have a deviated septum, or your nose was broken and is now badly misshapen, or you were born with a deformity in the nose and can't breathe out of it properly, then a rhinoplasty would be the medically appropriate solution. You do need your nose, and fixing it isn't always exclusively a cosmetic thing.

The same for a blepharoplasty - a relative had that done because his eyelids were sagging so far down that he was having trouble seeing and the eyelashes were turning inward and irritating his eyeballs. He had the excess skin removed and a few weeks later, all was well again.

On the other hand, getting an eyelid lift just because you want to look younger - shouldn't be covered in the first place. And getting a nose job just because you don't like how it curves outward at the ridge - is also a cosmetic thing and shouldn't be covered.

For things like that, it's important to know WHY there's a recommendation for a procedure. If it's medically necessary, it should be covered. If not, then no. A pre-auth is really a matter of paperwork UNLESS you're dealing with an insurance company that typically rejects pre-auths.
Yes, off topic sort of but I have dental insurance through my job and needed implants in my upper left back but insurance won’t cover it because it’s considered “cosmetic” even though you can’t even see it and I need it to eat. I had to go to Costa Rica ( the best dentist I’ve ever been to) to get it done for a reasonable price.