Insurance and Migraine Surgery

The cost of migraine surgery is a controversial topic, and this is compounded significantly by the treatment of migraine sufferers by health insurance companies.  The complexity of health insurance in America is on brilliant display when it comes to headache patients seeking long-lasting relief from nerve decompression surgery.  In short, the willingness of insurance companies to pay for migraine surgery is variable.  Some insurance companies, such as Blue Cross of CA, always refuse to pay anything for migraine surgery.  Despite Dr. Lowenstein’s MULTITUDE of phone calls, the “physician experts” at Blue Cross of CA have (seemingly proudly) stated that they refuse to pay for migraine surgery and don’t see that changing any time soon.  Other insurance companies do seem more willing to help their participants, though complete coverage is rare.

Because of their inconsistency in covering Migraine Surgery, Dr. Lowenstein and our Migraine Specialty Center cannot accept insurance in a blanket manner.  Doing so would result in a lack of payment that would prevent the Center from staying open.  Costs associated with keeping the Center open need to be met and the lack of payments by insurance would not allow that to happen.  While Dr. Lowenstein would love nothing more than to be able to provide free services to patients in pain, the costs of staff salaries, office supplies, and office mortgages unfortunately prevent that approach.

HOWEVER, both Dr. Lowenstein, as well as the Surgery Center, consistently bill patient insurance for all care provided.  (The only exception here is Medicare, as neither Dr. Lowenstein nor the Surgery Center accepts Medicare.)  Separate costs are associated with the professional services of Dr. Lowenstein and the Surgery Center where migraine surgery is performed.  Though Dr. Lowenstein owns both his practice as well as his surgery center, the costs associated with running a medical practice are quite different than the costs associated with a surgery center.  Insurance companies are billed separately for each of these aspects of surgery, and when the insurance do provide funds, patients are reimbursed up to the full amount paid for each part of their care.

The Cost of Migraine Surgery

The cost of migraine surgery depends on the areas that are treated, so there is not a single price that we can provide that would apply to all migraine surgery patients.  That said, the total costs of care including all doctor’s visits, as well as professional fees and surgery centers, usually range from $10,000 to $17,500 per surgery depending on whether the surgery is on just the left or right side or both sides.  For perspective, according to newchoicehealth.com, the average cost of arthroscopic knee surgery in the United States is $18,975, and knee surgery rarely has the impact on patient well-being that migraine surgery does.

 

Following your consultation with Dr. Lowenstein, you will be given an exact and complete cost of care.  There are no hidden costs to patients, and all costs are presented to patients upfront so there is no ambiguity.  For more information about your specific case, please call our patient care coordinator at 805-969-9004.

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