Bunions are a very common foot deformity that can be successfully fixed by a simple surgical procedure. It’s the most effective way to treat this condition, but is minimally invasive bunion surgery covered by insurance, or will you have to pay for it?
Check With Your Providers Is Minimally Invasive Bunion Surgery Covered by Insurance
Minimally invasive bunion surgery can be expensive, and in most cases, it’s covered by health insurance. Depending on your provider, it will either be fully or partially covered. In case the cost of bunion surgery is only partially covered, you will have to pay the difference out of pocket. Make sure to contact your provider and check.
What Factors Influence Insurance Coverage
There are several factors that affect your insurance coverage when it comes to bunion surgery. Here are all the factors you should consider.
Insurance Plan Type
Different providers offer different insurance coverage plans when it comes to foot care. You need to check your plan and see if it covers the procedure.
Whether or not the surgery will be covered by insurance depends on the nature of the procedure. If it’s done for cosmetic purposes, and the bunion isn’t causing you any pain or discomfort besides its physical appearance, insurance won’t cover it as it isn’t a medical necessity.
However, if the bunion is causing you pain or difficulty when walking or running, a medical intervention is necessary, and as such, it needs to be at least partially covered by insurance.
Preauthorization and Referrals
Before you schedule the surgery, you will need preauthorization from your provider – approval that they will pay for it. When filing for an insurance claim, you will need to submit a referral from your medical professional that the service in question is a medical necessity.
In-Network vs. Out-Of-Network Providers
One of the most important factors that determine if your insurance will cover the cost of the procedure is whether your service provider is in-network or out-of-network. In-network providers are participating providers, meaning they are a part of your insurance plan. If a participating provider performs your procedure, you will either be fully insured or pay at a discounted rate. On the other hand, out-of-network providers don’t accept your insurance plan, and you will have to pay the full price.
What Are Some Potential Out-Of-Pocket Costs You Should Consider
Besides the cost of the surgery itself, you will also have to pay for:
- Follow-up appointments during the recovery period,
- Prescription medication like painkillers,
- Any additional interventions in case complications arise.
Are There Some Alternative Financing Options?
If you can’t afford the out-of-pocket cost, talk to your doctor and see if the cost can be reduced, or turn to charity-care programs for help.
Consult Your Doctor in Miami About the Financial Options Available for Your Surgery
Are There Specific Codes or Documentation Required for Insurance Coverage?
When you decide to file for a health insurance claim, you will need to fill out the claim form and submit certain documentation such as proof of ID, your policy information, and the doctor’s prescription. You will also need to know the procedure code when filling out the form. The CPT code for bunion surgery is CPT 28298.
How Can I Find Out if My Insurance Covers Minimally Invasive Bunion Surgery?
Contact your provider and check whether your insurance plan covers the procedure.