A member asked:

When would otoplasty be covered by insurance? my insurance doesn't cover elective cosmetic surgery, so i thought it wouldn't cover otoplasty to fix my big ears. but i read that sometimes insurance will cover it. in what situations would otoplasty be consi

7 doctors weighed in across 4 answers
Dr. Richard Arden answered

Specializes in Otolaryngology-Head and Neck Surgery

I : I suspect that coverage benefits for otoplasty vary depending on the insurer, but, in general anything that is considered purely cosmetic wouldn't be covered. I have had several insurance companies cover otoplasty under the umbrella of congenital deformities.

Answered 3/21/2017

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Dr. Thomas Lamperti answered

Specializes in Facial Plastic Surgery

Whether : Whether you're insurance would cover an otoplasty depends on the company itself and the actual indication. Some insurers say that otoplasty is not a coverred benefit no matter the indication whereas others cover it if it is seen as a congenital deformity.

Answered 3/21/2017

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Dr. Benjamin Cilento answered

Specializes in Facial Plastic Surgery

Hi, : Hi, in general, insurance companies are "for profit"... Therefore as time goes by they will be looking to continually erode what is covered or how much of it is covered... In the early 90's i had a much easier time getting otoplasty covered as a congenital deformity... Nowadays it is very difficult to have an insurer cover it even though the nature of ear deformity has not changed... Unfortunately physicians do not make these medical decisions...Rather it is made by business men and women for fiscal reasons... Good luck in your endeavor...

Answered 1/7/2019

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Dr. Louis Gallia answered

Specializes in Surgery - Oral & Maxillofacial

Injury or: If ear problem due to injury, would be covered. Might be covered if deformity is extreme and there are emotional concerns. See a facial plastic surgeon for best results.

Answered 11/1/2015

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