Cost and Insurance

* Always obtain surgery costs and insurance information directly from your surgeon of choice’s office. Your surgeon’s staff is experienced at handling insurance inquiries and can help you obtain accurate and up to date information that you will require prior to planning for surgery. Surgery fees are always subject to change and are affected by insurance changes that may occur annually through your insurance provider.

* Insurance fees and final billing figures can vary quite a bit. Some changes that can be reflected in final billings along with adjustments are: the location where the surgery took place, the duration of the procedure, additional requirements (surgical items, etc…) needed during the procedure, medical assistant or additional attending physician/surgeon, anesthesiology fee per hour, etc… This can make medical bills and insurance negotiated rates very confusing. Seek the advice of the surgeon’s office and your individual insurance representative on all final figures.

Surgery costs to have Medpor or Rib Graft surgery performed along with Atresia Repair surgery may cost anywhere between $55,000.00 (USD) per ear to over $100,000.00 (USD) per ear depending on adjustments and the number of surgeries needed. This may not include travel expenses. Depending on where you are traveling from, how long you have to stay, and what you end up doing, travel expenses could range from $6,000.00 to over $30,000.00

Below are only “examples” of “approximated” fees for what these surgeries may cost. Again, these fees can vary based from surgeon to surgeon and how much the medical facility/surgery center charges where the surgery takes place. The below is only meant to provide you with an idea of how much these surgeries may cost for your peace of mind…

Approximated Cost for Rib Graft Surgery With Insurance Coverage:
4a. Generalized costs for Rib Graft all range and vary per surgeon and per stage. Each stage may range anywhere between $8,000.00(USD) to over $25,000.00(USD). It depends on the complexity of the ear itself that is being reconstructed, skin graft, time for surgery, how many stages will be required, and of course medical/hospital expenses, including anesthesia costs. Again, depending on insurance coverage, out of pocket expenses vary across the board. Total costs can be over $125,000.00 per ear once an ear has been reconstructed.  * If you find a surgeon who is “in-network” with your insurance coverage plan, many families may end up paying a total of anywhere from $0 (USD) to about $2,500.00 (USD) depending on your deductible and copay instead of hundreds of thousands of dollars.  Also, just because a surgeon may be considered “out-of-network” does not mean that you and that surgeon’s office can’t help get him/her to be considered “in-network” and have better coverage.  Many surgeon’s offices have specialized staff who are experienced at working with insurance companies and finding the best possible way for you to be able to afford these surgeries.  Please don’t be discouraged.  It is always possible to appeal if necessary and the staff at many surgeon’s offices can help you with this paperwork process as well if for some reason your insurance denies your claim for one reason or another. 

Approximated Cost for Rib Graft Surgery Without Insurance Coverage or for International Patients:

4b. * A discount may be applied due to not having insurance coverage, private insurance or for traveling overseas from another country. However, you may be asked to pay in full or to pay a certain amount up front, prior to surgery. Total costs may be over $125,000.00 once an ear has been reconstructed.  * If you find a surgeon who is “in-network” with your insurance coverage plan, many families may end up paying a total of anywhere from $0 (USD) to about $2,500.00 (USD) depending on your deductible and copay.  Also, just because a surgeon may be considered “out-of-network” does not mean that you and that surgeon’s office can’t help get him/her to be considered “in-network” and have better coverage.  Many surgeon’s offices have specialized staff who are experienced at working with insurance companies and finding the best possible way for you to be able to afford these surgeries.  Please don’t be discouraged.  It is always possible to appeal if necessary and the staff at many surgeon’s offices can help you with this paperwork as well if for some reason your insurance denies your coverage for one reason or another. 

How Do I know if the Surgeon I Have Selected Is Covered By Insurance?

Once you have selected your surgeon of choice, contact his/her office and have that office run your insurance so you know what you may be looking at dollar wise. Also, the surgeon’s office can tell you if they accept your insurance or not. For example, some surgeons do not accept TriCare or Blue Cross/Blue Shield, but do however accept a majority of most other insurances.  It is always possible too to try and get that surgeon to become “in-network” with your insurance company by proving that this is the “only” or “best skilled surgeon” in this area or by showing how by going to “this” surgeon you are cutting costs and procedure time, etc…making it potentially cheaper for insurance coverage and cutting the number of surgeries that would be required through another surgeon or technique.  All of these ideas may help qualify the surgeon you are considering to be covered as “in-network.”

How Do I Plan To Come To the United States For Surgery If I Am An International Patient?

Contact your surgeon’s office whom you have decided on having surgery with. The office should be able to provide you with the appropriate documentation that will be required to be filled out in order to come to the US for surgery or another country. You must take appropriate measures when traveling abroad to have surgery! For example, you can not utilize a work Visa for having surgery nor can you travel to have surgery claiming with your passport that you are strictly here for vacation or business. There are necessary forms and documents that will cover you legally for traveling during surgery. With the appropriate documentation, you should have no problems traveling abroad for surgery.  You may also want to visit the following link for more details:  http://travel.state.gov/visa/temp/types/types_1262.html#10

Comments

  1. joy22kar says:

    We are having surgery with Dr. Brent this summer. Margaret has taken care of all the paperwork and getting approval through the insurance company. We are covered under Highmark Blue Cross of Pennsylvania and they will be covering the surgery. I am so excited. This is fantastic news. It can be done, but make sure you give Margaret everything she needs.

Leave a Comment

Translate »