Over the past 10 years, corporate America has quietly shifted much of the cost of health care to their workers by changing to “high deductible” health insurance plans that stick patients with thousands of dollars of medical bills. This means that even patients with insurance may find hernia surgery out of reach.
We are seeing increasing numbers of patients with insurance and high deductibles, who find that they’re not really insured for hernia surgery, which will still cost them many thousands of dollars. In fact, it is often much less expensive to pay $2,600 for their surgery (preferably from a Health Savings Account–see below) and not even use their insurance.
Because even with insurance, you may end up spending a lot for your hernia surgery. And it’s the questions you don’t ask that can cost you thousands of dollars.
In general, the cost of surgery is the sum of the following charges:
- The charge for the operating room
- The charge for the anesthesiology
- The charge for the surgeon
When treating a patient with health insurance, the doctors and the hospital will often have a contract which limits how much they can charge. Unfortunately, most doctors and hospitals do not want to disclose these contracted rates until after the surgery. This makes it impossible to estimate the real cost of the operation beforehand.
In general, surgery at hospitals is much more expensive than at surgery centers. In fact, we have found that hospital charges alone can be four or five times as much as the total cost in our surgery center.
At AffordableHerniaSurgery.com, we believe in complete transparency in disclosing what our surgery will cost YOU. So these are our estimated total costs of your surgery at our center when using insurance. These estimates include the charges for anesthesia, the surgery center, and your surgery. These amounts vary depending on the insurance company because of the differences in contracted rates. They can also vary based on the time and equipment used.
Procedure | CPT code | Affordable Hernia Surgery | Blue Cross | United Health Care | Cigna | Aetna |
Repair Inguinal hernia | 49505 | 2400 | 2650 | 3800 | 5000 | 5000 |
Repair Recurrent Inguinal hernia | 49520 | 2400 | 3000 | 3900 | 4100 | 4100 |
Repair Incarcerated Inguinal hernia | 49507 | 2400 | 3000 | 3825 | 4100 | 4100 |
Repair Umbilical hernia | 49585 | 2400 | 2650 | 3750 | 4550 | 4832 |
Repair Incarcerated Umbilical hernia | 49587 | 2400 | 2700 | 4000 | 3850 | 4600 |
Repair of Ventral hernia with mesh | 49560 + 49668 | 2700 | 4500 | 5575 | 5533 | 5425 |
For further details on insurance deductibles and paying cash, please read this.
HEALTH SAVINGS ACCOUNTS
This is an amazing way to save money on health care. Everyone with a High Deductible Health Plan is allowed to take a tax deduction for money placed in a Health Savings Account (HSA). This money can be used for anything medical, like dental care, eyeglasses, mental health services, and all medical expenses that don’t get paid for by insurance. By making these expenses tax-deductible, you are actually getting a significant discount on their cost. Most HSA accounts have a debit card that makes them very easy to use.
And, of course, you can use your HSA funds to pay for hernia surgery! This saves you hundreds of dollars, depending on your tax rate.
Here is more information on HSA’s..
https://www.fool.com/retirement/2017/11/06/2018-hsa-changes-the-latest-on-health-savings-acco.aspx
We STRONGLY encourage patients with high deductible insurance plans to set up an HSA and use those funds for their hernia surgery. It saves lots of money!