Most patients know that plastic surgery is not always covered by insurance. In fact, it’s rare.
However, there are some exceptions. For instance, a breast reduction performed on a patient who is struggling with back, neck, and shoulder pain might be covered by insurance because this procedure would be “medically necessary”. Health insurance companies look at whether a procedure or treatment is “medically necessary” before they make a decision on coverage.
So is otoplasty covered by insurance?
With an otoplasty procedure, things may be a bit different. In the following article, we will discuss what otoplasty is and why it is performed as well as what health insurance coverage may look like for various patients.
What Is Otoplasty?
Otoplasty, also known as cosmetic ear surgery or sometimes as ear pinning, is a procedure aimed at reshaping or repositioning the ears to achieve a more balanced look. This surgery is commonly performed as an elective procedure to correct prominent or protruding ears, but it can also address other ear irregularities.
Who Is a Good Candidate for Otoplasty?
The best candidate for otoplasty is someone who feels self-conscious about the size or shape of their ears. Ideal candidates include both children (typically around age five or older) and adults. The best age for otoplasty depends on the individual, but it’s usually performed after the ears have fully developed. Patients must be in good health with realistic expectations.
Will My Otoplasty Be Covered by Insurance?
Is otoplasty covered by insurance? It depends on the reason for the surgery. Generally, insurance companies do not cover cosmetic ear surgery because it is considered elective. In other cases, however, it may be covered in part or in full.
Can Otoplasty Be Covered by Insurance to Restore Hearing Function?
In some cases, ear surgery may be covered by insurance if it’s necessary to restore hearing function or correct another fundamental issue. If a congenital ear deformity affects hearing, the surgery might qualify for coverage.
Patients should consult a plastic surgeon and their insurance company to explore their options.
How Much Does Ear Surgery Cost?
Ear pinning surgery costs can vary based on several factors. First, some surgeons charge more for their services based on their specialties and expertise. If they excel with ear surgery, they will be in higher demand and charge more.
Another important factor is the complexity of the procedure itself. If the surgery involves intricate techniques or additional corrections, this may increase the overall cost. Anesthesia fees associated with otoplasty surgery will also affect otoplasty cost. Otoplasty can be performed under local anesthesia or general anesthesia.
Surgical facility fees are another component to think about. The type of medical facility where the surgery is performed can vary in price. Additionally, any required pre-operative tests or consultations may contribute to the overall cost of the procedure. Lastly, patients should consider follow-up visits, which are essential for monitoring recovery.
How to Get Otoplasty Covered by Insurance
To increase the chances of getting otoplasty covered by insurance, it’s best to first meet with a board certified plastic surgeon to find out if your surgery is medically necessary. If it is, pre-certification may still be required for insurance coverage.
Pre-certification is a process where your insurance company evaluates the medical necessity of the procedure. Providing documentation from your plastic surgeon can help support your case.
How Can I Pay for Otoplasty if Insurance Won’t Cover It?
Patients have several options for paying for otoplasty. Many choose to use health savings accounts or flexible spending accounts. Others may explore financing options or payment plans offered by the surgeon’s office or through third-party entities.
FAQ: Otoplasty Procedures
What is the recovery process like after otoplasty?
Recovery typically involves wearing a compression headband around the ears for a week or two to support the ears as they heal. Patients can usually return to normal activities within a week, but strenuous activities must stop for several weeks.
Will I Have Otoplasty Scars?
Any cosmetic procedure will leave some form of scarring. However, otoplasty scars are typically minimal. Your incisions will usually be made behind the ear, making them less visible in general. Proper post-operative care can further minimize scarring.
Are there any risks associated with otoplasty?
Otoplasty risks include infection, scarring, and changes in sensation (short- or long-term). Your surgeon will talk to you about risks at your consultation.
How do I find an otoplasty surgeon?
To find the best otoplasty surgeon, research local plastic surgeons who specialize in ear surgery. Read reviews and check their credentials to ensure they are board-certified. Scheduling consultations with multiple surgeons can help you find the right one to fit your needs.
Contact Us to Schedule a Consultation
All health insurance plans and health insurance companies are different. If you think your insurance may cover otoplasty, you are, of course, welcome to investigate this on your own, and we will do our best to assist you.
To learn more about ear surgery and find out if you’re a candidate, please call us today and schedule a one-on-one consultation with board-certified plastic surgeon Dr. Ashley Steinberg.