Can I Use My HSA to Pay for My Nose Job or Rhinoplasty?

Rhinoplasty surgery is a surgery that addresses both form and function of the nose. In contradistinction, septoplasty, which simply involves removing and not straightening of the septum, addresses only function. Septoplasty is easy to get covered under insurance, whereas rhinoplasty does not get covered through insurance as it is considered cosmetic.

However, there is a loophole.

You may still be able to use your Health Savings Account(HSA) to pay for rhinoplasty surgery. Rhinoplasty surgery typically involves several functional maneuvers that are needed to improve both appearance and breathing. It includes septoplasty as well as internal splinting which both contribute to improved breathing. For this reason, rhinoplasty may be deemed medically necessary based on IRS rules.

Using your Health Savings Account (HSA) to pay for rhinoplasty surgery can be possible, but there are some considerations and steps you should take:

1. Check Eligibility: Rhinoplasty surgery must be deemed medically necessary to qualify for HSA funds. Cosmetic procedures are typically not covered unless they address a medical need, but rhinoplasty can address several medical needs, such as:
   1. Trouble Breathing 
   2. Snoring/Sleep Apnea
   3. Headaches(60% of headaches are considered rhinogenic in origin)
   4. Frequent Sinus Infections
2. Consult with your Rhinoplasty Surgeon: Discuss your situation with your surgeon. They can provide documentation and justification for the medical necessity of the procedure, which may be required by your HSA provider.
3. Review HSA Guidelines: Understand your HSA plan’s rules and guidelines regarding eligible expenses. Some HSAs have specific requirements or documentation processes for using funds on medical procedures.
4. Keep Documentation: Maintain thorough documentation of the medical necessity of the rhinoplasty, including any diagnoses, treatment plans, and recommendations from healthcare professionals.
5. Submit Claims: If your rhinoplasty qualifies as a medical expense under your HSA plan, you can use your HSA funds to pay for it. Keep receipts and any other relevant documentation for your records.
6. Follow IRS Regulations: Ensure that the expenses you claim comply with IRS regulations for HSA withdrawals. Non-qualified expenses may incur taxes and penalties.
7. Consider Reimbursement: If you’ve already paid for the rhinoplasty out of pocket, you can reimburse yourself from your HSA. You can treat your HSA like a bank account to cash out and pay yourself back. There is no tax penalty for this. Also, remember that there is no time limit on how you can pay yourself back. This means you can spread your payments over several years. For example,
   • Mary doesn’t like her crooked nose and wants a rhinoplasty. She has a septal deviation or perhaps gets headaches. These are medically qualifying conditions. She pays $10,000 for her rhinoplasty. She has several options for payment through her HSA.
     • Option 1-Mary has the funds. Mary pays the full amount for her rhinoplasty with her HSA funds at time of service. She can either use her HSA card, or use a credit card or cash to pay for the surgery. She can then withdraw from her HSA bank account to pay off her credit card(interest included) or pay herself back.
     • Option 2-Mary does not have the funds. Mary does not have the full amount for her rhinoplasty within her HSA or bank account. She can then finance the balance for the surgery through a credit card, bank, or Carecredit. HSA rules allow you pay for medical expenses over the course of several years. She can use successive years of HSA contributions to finance her surgery purchase.

Choose a Rhinoplasty Expert?

It is important that you choose a Plastic Surgeon experienced in rhinoplasty surgery. Rhinoplasty surgery is a field all in itself. It is considered by many Plastic Surgeons to be the most difficult of all procedures. To be proficient in rhinoplasty requires a very specific skill set and a prolific knowledge of rhinoplasty techniques. It is a finesse surgery that takes time and a commitment to perfection. Patients should be wary of any surgeon who simply  does an “add on” rhinoplasty at the time of septoplasty. Excellent rhinoplasty results take 3-4 hours to achieve.

Dr. David Graham is a rhinoplasty expert. He is a member of the both the American Rhinoplasty Society and Rhinoplasty Society of Europe. He has pursued advanced training with the world’s finest rhinoplasty surgeons, such as Dean Toriumi, Rod Rohrich, Mario Ferraz, and Rick Davis. In addition to traveling all over the US to hone his craft, he has traveled to Italy and Germany to study with the world’s best surgeons. As a result, he is at the forefront of rhinoplasty techniques, including the usage of ultrasonic rhinoplasty. He performs both primary and revision rhinoplasty procedures out of his state of the art surgical suite. 

Contact Board Certified Plastic Surgeon, David Graham, MD, in Rochester, New York

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Dr. Graham receives patients from Rochester, Victor, Fairport, Pittsford, Brighton, Irondequoit, Henrietta, Syracuse, Buffalo, New York and surrounding areas.