Cost of H removal?

macyharper · #1 11-11-2008, 05:41 PM

So I've been wondering about the cost of removal for quite some time. My daughter is now 5 months old and I was hoping that her scalp H would just somehow start shrinking (!!!!) but it has only grown and grown, like I know it's supposed to. We have been seeing Dr. Burns in Dallas, and he is only willing to follow the "wait and see" approach.

I initially got in touch with one of Dr. Waner's associates, and considered scheduling a removal surgery, but my husband and I thought we would wait a while and see what the H did before making any decisions. I remember being told that 5 months old was when Dr. Waner could perform the surgery.

We have United Healthcare insurance, but I realize that Dr. Waner doesn't take insurance. Can I expect for my insurance to pay for any of the surgery? Can anyone who had removal surgery give me an idea of how much it could cost? I hate to say that cost is a factor, but it is. Especially given the current poor economy.

TIA.

jgoodman0814 · #2 11-11-2008, 05:53 PM

youur insurance is supposed to pay for the removal if the hemangioma was present at birth. dont take no for an answer. also, our daughter just had hers removed by a dr in cinn oh, and the pre insurance bill was 15 thousand dollars. after insurance paid, we owed about 1500, then we applied for the hospital financial assistance and our final bill was 400! you can email me if you have any questions.

macyharper · #3 11-11-2008, 06:21 PM

Well, her H appeared 2 weeks after birth. Does that count as being present at birth?!

jgoodman0814 · #4 11-11-2008, 08:41 PM

ours did. her dr told me that it was conginital if it was apparent in any way. and hers showed up as a small bruise on her arm, and a small pin dot on her neck. sometimes, if your lucky, you can get the dr to write it up as conginital.

lpm · #5 11-12-2008, 10:46 AM

Cost can vary from doctor to doctor and also depends upon your particular case, though $15K sounds like a reasonable ballpark figure.

I think if you look at some cases on these boards and others, you will see some dramatic cases of involution with scalp hemangiomas. If it is not causing any problems, I would personally wait longer - maybe see if there has been any sign of involution by age 18 months -2 years. If not, then perhaps schedule surgery.

Though Dr. Waner is great, remember that there are other doctors out there that can do the surgery and accept insurance. We have United Healthcare, and we went to Dr. Reinisch (traveled from PA to CA). I know that he is now affiliated with a different hospital, but when my kiddo had her two surgeries, his bill was covered 100 percent. There are others out there too that would do the surgery, though you will probably have more options if you wait until she is over a year old. Good luck.

mmarrari · #6 11-14-2008, 02:44 PM

Hi, Dr Waner operated on my daughter and insurance paid 100%. He DOES take insurance, he is not any networks though, so you have to go about it as an out-of-network request. Our daughters hemangioma also appeared at about 2 weeks old. Aetna put on a fight but we went through the appeal process and got everything covered, for both surgery and later laser. They never said anything about the congeital vs. non congenital issue though, and they never even tried to say it was cosmetic (although my daughter's H was causing severe astigmatism and he eye was half way closed). They first denied it saying that there we in-network specialists that could do it and referred me to a few. It was my job then to prove that Dr. Waner was the most skilled for this surgery, and they ended up paying. I had to call the Drs they suggested, ask how many surgeries they had done, how many hemangiomas, how many in the eye area, etc, and then go back to Aetna with the facts. I can help you with this and send you samples of the letters we wrote if you decide to go that route.
Good luck with whatever you decide to do. Marina
PS. Regarding the cost, it will depend on the Dr, if your baby is going under general anesthesia, and whether you are paying for it or the insurance is. Most Drs will work out a lower fee and a payment plan if you are paying out of pocket.

mtk76 · #7 03-05-2009, 11:30 PM

I'd love to get some samples of the process you used with Aetna since I am going to have to do this soon.

If you could post here or send to MarkTKelly@yahoo.com I'd appreciate it.

CarrieChris · #8 03-07-2009, 01:26 AM

Dr. Waner accepts all insurance payments, however, he is not an in network provider. This means that the insurance companies will pay him at a lesser rate since he is out of network and that the doctor then has the right to bill you the difference. Each insurance company is different. You may be able to get your insurance company to give you an in network or gap exception if they have that.

Best of luck to you.

mtk76 · #9 03-12-2009, 08:36 PM

I was wondering if you had the name/phone # (or email address) of Dr. Waners insurance/payment employee. I used to have it a few yrs ago when I saw him but now we are ready for my daughter to have surgery and I'd like to work out the insurance details now.

Thanks if you can help.

kandbsmom · #10 03-16-2009, 01:49 AM

We had our daughter's scalp H removed a year ago when she was 4 months old. We also have United insurance, and they did cover it. The dr's office dealt with them, so I'm not sure how they got it covered, but they did.