Balloon sinuplasty is a type of nasal surgery that helps to treat severe rhinosinusitis and sinus inflammation. Approved by the FDA in 2005, balloon sinuplasty is an extremely effective method for reducing symptoms of rhinosinusitis. Balloon sinuplasty is also being covered in full more and more often by medical insurance companies.
Is Balloon Sinuplasty Covered by Medical Insurance?
Balloon sinuplasty is minimally invasive and does not require any cutting or loss of tissue or bone. This makes for a shorter recovery time for patients and an overall safer procedure. Because of this, balloon sinuplasty is fast becoming the top choice for chronic or severe sinusitis that does not respond to other therapies. Studies have shown that the majority of patients who undergo the procedure report dramatically improved symptoms in just a week after the procedure, which lasts up to a year. Because of this efficiency and how safe the procedure is, The American Academy of Otolaryngology–Head and Neck Surgery (AAO-HNS) called for medical insurance companies to consider balloon sinuplasty a standard coverage service.
Most insurance plans cover it.
Increasingly, balloon sinuplasty is covered by the vast majority of insurance plans. A few medical insurance policies consider balloon sinuplasty an elective procedure, which means that it may not be covered. Out-of-pocket costs for a balloon sinuplasty that is not fully covered by medical insurance depends on the specifics of a patient’s medical insurance plan, the severity of their symptoms, and whether the condition is improved with other medical therapies.
There are also a few medical insurance plans that may require pre-authorization prior to approval. If your plan needs pre-authorization, the office where you are having your balloon sinuplasty procedure should handle this for you. To be certain of your coverage, reach out to your insurance provider ahead of time to find out your specific coverage policy.
If you suffer from chronic rhinosinusitis and sinus inflammation, you might be a good candidate for a balloon sinuplasty procedure, especially if other medical therapies have not improved your symptoms. If you’re unsure about insurance coverage, give your provider a call and tell them about your case. Balloon sinuplasty is a safe and effective solution for chronic sinus inflammation.
