Gamma Knife Surgery: Cost & Insurance Overview

Planning for any medical procedure includes anticipating the costs involved, which can sometimes be difficult to understand. Add insurance to the equation, and many patients find themselves overwhelmed when trying to navigate through the fine print, adding unnecessary stress to the entire process.

There is no reason you should be confused or left in the dark about the cost of your upcoming treatment. It is important you are comfortable with all aspects of your procedure, including the finance and insurance side of things. The following information will address some questions you may have about Gamma Knife surgery costs and insurance coverage and will help clarify how the process works.

Is Gamma Knife Surgery Covered by Insurance?

Generally speaking, Gamma Knife surgery is a medical procedure that is covered by your insurance policy as long as your treatment center accepts your health insurance. Many treatment centers will share a list of insurance companies they work with on their website. You can also call and someone there will be able to tell you whether or not they accept your coverage.

Why Your Medication Is Not Working

There are a few different types of medications used to treat trigeminal neuralgia. Some help ease the pain directly, while others try to provide relief by eliminating the cause of the dysfunction. Sometimes the nerve is overstimulated, and medications can help inhibit it from firing excessively and causing pain. Anti-seizure medications and some antidepressants can help in this fashion and are typically the first step your doctor takes in treating your trigeminal neuralgia.

However, sometimes your trigeminal neuralgia medication does not work. This may happen because your condition is a result of something physically pressing on the nerve and causing it to fire inappropriately. Sometimes a tumor is causing the pressure, but it is most commonly a blood vessel near the brain that is the culprit. When this is the case, further intervention to remove the impingement may be necessary in order to provide relief.

Your Next Steps

If you feel like your trigeminal neuralgia medication is not working, it is important you schedule an appointment with your doctor immediately. Your doctor will discuss your symptoms and whether you have received any relief from your medications, which ones and to what degree. Sometimes imaging may be necessary to help your doctor determine the next appropriate steps. It is important you are working with someone experienced in treating your condition, such as a neurologist, as you move into your next phase of treatment. If you are considering treatment at The Valley Gamma Knife Center, it may be helpful to know that the center accepts many insurance policies, including:

  • Horizon Blue Cross Blue Shield of New Jersey
  • Cigna
  • Oxford Health Plans
  • United Healthcare
  • Medicare
  • AmeriChoice

Even if your policy is not listed above, Valley’s Patient Financial Advocates is available to work with you to come up with a financial solution and answer any questions you may have.

How Much Does Gamma Knife Surgery Cost?

The answer, in this case, is that it depends on a variety of factors. The cost of your procedure will vary from the next patient and will need to be discussed with a specialist at your specific treatment center. However, it can be helpful to know which factors may influence your Gamma Knife surgery cost.

First, a lot will depend on whether or not the treatment center accepts your insurance policy. As discussed above, take the time to find out whether or not they accept your coverage. If not, you may wish to speak with your insurance company about reimbursement when you pay out of pocket to understand how the process and your coverage will work.

Next, you will need to consider whether or not your treatment center is in or out of your insurance policy’s network. You can generally expect to pay more overall if you visit an out-of-network provider. Your insurance company may have a searchable online database to find a Gamma Knife treatment center in your area. However, it is safest to call and speak to an insurance representative directly to ensure you are receiving the most up-to-date information and avoiding unexpected costs.

Finally, your Gamma Knife surgery cost is going to depend on your individual treatment plan. While some patients only require a single session, your condition may necessitate multiple treatment sessions, thereby increasing the overall cost. Your personal doctor will be able to discuss your treatment plan and the number of sessions required, as well as how this might influence the cost of treatment.

How Does Gamma Knife Surgery Cost Compare to Open Surgery?

To treat a head or neck condition, some patients are candidates for either traditional open surgery or Gamma Knife surgery. Although both are viable treatment options, a recent study concluded that the cost of Gamma Knife surgery was 40.9 percent to 58.8 percent the cost of traditional open surgery.

How Do You Determine Insurance Coverage and Costs?

It’s no secret that health insurance can be confusing. Thankfully, some treatment centers employ specialists who are there specifically to help you navigate the insurance system and understand how it applies to your individual treatment. If your doctor’s office does not have a benefits specialist on staff, your insurance company may be able to answer your questions. However, you will need to have specific information about your doctor and medical codes for any procedures you are scheduled for.

The team at The Valley Gamma Knife Center is available to work with you to determine exactly how your Gamma Knife surgery cost will be covered by your specific policy. Valley’s Patient Financial Advocates can help you understand your costs and coverage, regardless of your scheduled procedure or insurance policy. Should your insurance company not be on the list of those Valley works with, the team can work with you to determine an insurance solution.

Understanding Your Gamma Knife Surgery Cost and Coverage

Now that you have a better understanding of what can affect your Gamma Knife surgery cost and how insurance comes into play, you can discuss your individual upcoming treatment with your doctor or someone at your treatment center. Find out if you have a benefits specialist available to help you review your procedure and how it will be covered by your specific insurance policy.

Being informed about your upcoming procedure and understanding how your insurance coverage will apply to your treatment can help prevent unexpected costs after the fact. If you take the time to sit down with someone who can thoroughly explain your benefits before your treatment, you may find that the peace of mind it gives you will allow you to rest easier during your recovery.

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Get Your Questions Answered, By a Real Person.

Our Patient Liaison is here to help you understand your next step. After discussing your specific case, she can help you navigate your medical records, answer insurance questions, and connect you with one of our nurses, at no charge to you.

We now offer the convenience of virtual consultations via computer and smartphone. To discuss your specific case with our Nurse Navigator, call 201-571-6494.