Scoliosis surgery is a life-changing surgery that can help you regain mobility and relief from pain. If it’s been recommended by your doctor, you’re probably starting to consider several important questions. How long is recovery? Will I regain mobility? Can I stop using pain medication? Is scoliosis surgery covered by insurance?
You may be concerned that your scoliosis surgery won’t be covered by your insurance. While this is a valid concern, the following information will help you better understand the cost associated with this procedure and how insurance works. This will let you concentrate on the most important task at hand – finding relief from your scoliosis symptoms!
10 Variables that Influence Scoliosis Surgery Cost
There are a number of factors that play into the total for your scoliosis correction surgery. It’s not just the procedure itself but also a number of other variables that contribute to the overall cost.
1. Pre-surgical tests. Because scoliosis surgery is considered a major surgery, your spine surgeon will require a number of tests before you are “cleared” for the operation. These can include:
- Bloodwork
- Imaging studies such as CT scans
- X-rays
- MRIs
- Bone density testing
2. Blood donation. It is often recommended by neurosurgeons that those undergoing scoliosis correction surgery donate a few units of their own blood in the weeks following up to surgery.
3. The surgical team. Your surgery will require not only the lead surgeon but also an anesthesiologist and team of other support staff. This may consist of OR nurses, surgical techs, anesthetists, and, in some cases, residents or med students and a physician’s assistant.
4. The surgical procedure. In addition to the staff costs, the surgical procedure itself is typically billed separately.
5. Surgical supplies. During surgery, a wide variety of disposable supplies are needed, from scalpel blades to suture material, gauze and sterile gloves to masks. All of these things are factored into the overall cost of your surgery.
6. Medications. Your surgery will require medications, both during the procedure itself and during the recovery period. These include anesthesia, pain medications and anti-inflammatories, among others.
7. Surgical implants. If your surgery requires implants such as plates, screws, rods or other instrumentation, this will be added to the total. Another added expense in this same realm is allograft (donor bone) material for the “fusion” aspect of your surgery. If you’re unsure which route you wish to go (using your own bone tissue, allograft material or synthetics), discuss the pros and cons of each with your surgeon.
8. Hospital stay. Another cost that is included in your surgical tally is your hospital stay. This typically lasts 4 – 10 days after your surgery. This will include your room, the staff that is caring for you and food.
9. Physical therapy. Many individuals that undergo a scoliosis correction surgery require physical therapy after their surgery. Most surgeons consider this an integral part of the recovery process. Physical therapy helps to strengthen muscles, increase flexibility, and teach proper posture.
10. Post-surgical bracing. While it’s not terribly common, your surgeon may recommend you use a brace following your surgery. Braces are used to help provide support to your spine while it heals. These braces are typically custom-made and can be expensive. If your insurance is unwilling to cover it, ask your doctor if they know of companies that will provide discounted braces. Many manufacturers are willing to work with individuals that don’t have insurance coverage for these types of devices.
As you can see, there is a lot that goes into a surgery — it isn’t just the procedure. It’s important to make sure you understand exactly what you’ll be requiring and how much it will cost. That way, there won’t be any surprises when you receive a bill for the portion your insurance may not cover.
How to Find Out What Insurance Will Cover
Each insurance policy is different with regards to what they will cover for a particular patient having surgery with a particular surgeon and hospital. This necessitates a candid discussion with your insurance representative. However, surgery is an established treatment for scoliosis, and, although it may require a lot of back-and-forth between you, your doctor, and the insurance company, ultimately your surgery should be approved if you are an appropriate candidate. The hospital or surgical facility where you’re having your scoliosis correction surgery can also help you navigate the portion of your surgery that will be paid for by your insurance provider.
Because each insurance carrier has different treatment protocols and schedules, be sure to ask any and all questions to your carrier and your medical team.
Scoliosis correction surgery can be one of the best decisions you’ll ever make for yourself. Don’t let insurance worries steer you away from getting the best treatment available. Between your surgeon’s billing office and the hospital billing staff, you should be able to understand all of the costs associated with your scoliosis correction surgery well ahead of your procedure date and prepare accordingly.
