Pectus Excavatum Surgery & Insurance Tips - Finding a Doctor and getting Insurance Cover
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I’m currently running a website on Pectus Excavatum and also have the Pectus Excavatum chest deformity and a lot of people ask me for tips on getting insurance cover as well as how to approach the whole surgery situations and dealing with common difficulties with doctors who don’t seem to understand how pectus excavatum affects you and just tell you to get over it and tell you there is nothing wrong with you.
Feel free to comment or ask me questions in the comment section.
Choosing a doctor
This is probably the most important place to start finding a general doctor who you can trust and understands your problems and needs. This is most important because many people run into doctors who have no clue about pectus excavatum and call it things like whole chest and concave area and they will pretty much give you textbook responses to your questions and you will leave there office feeling like you just paid to have the dictionary read to you.
I have had this many times where I would ask a doctor if there is anything I can do to improve the appearance of the chest or get a surgery and they will always respond with “Don’t worry about it , just live with it” but that’s not the truth you don’t have to live with it if you don’t want to there are so many ways to improve your pectus excavatum including exercise (see my pectus repair hubs) and the most popular nuss surgery procedure.
Having a good understanding doctor will work in your favour in the long run as it will make getting referrals and convincing surgeons to carry out the surgery much easier and most importantly a good doctor backing you up is invaluable when trying to get insurance cover for the expensive surgical correction procedure.
Remember like any doctor if you are persistent with them they will have no choice than to give you a referral and if all else fails, contact the specialist directly as I have done in the past and it works fine just remember to work out your game plan just incase the specialist is a little hesitant. From the specialists I have seen I can tell you that they are very welcoming and wont push the surgery on you but will tell you that they will be happy to perform the operation and believe it can help.
Surgery
The pectus excavatum surgery was long only considered for people with very severe pectus excavatum meaning it caused them real pain, pressure on organs or trouble breathing but now it is seen more of a cosmetic surgery. Which is good when you think about the trouble people went through getting surgeons to agree to do the procedure because know there are many surgeons all over the world doing the procedure.
With the surgery now being considered a cosmetic one, we have run into the trouble of the insurance companies being very had to convince to cover the costs of the expensive procedure. The key is to make it look less like a cosmetic surgery and more of a necessary surgery but I will talk about this later on.
Pectus Excavatum Surgery - Organizing the Surgery
So now for the part where you want to organize the surgery, this part will of course be a lot easier with a referral from your local doctor with a note describing your condition and difficulties you experience with the condition (usually heart pains, unable to take deep breaths, effecting fitness levels) that sort of thing. From my experience surgeons don’t need much convincing as It is considered a surgical procedure but for a difficult doctor, specialist or surgeon it is sometimes necessary to make the condition appear worse than it actually is by describing the troubles you experience.
To help support your surgery you should have most of the following including a local doctor referral letter 1- CT Scan of the chest / chest wall 2- Echocardiogram 3- Pulmonary function studies 4- Detailed note from your family physician on any significant past medical problems including your cardiac, respiratory and genetic history.
Pectus Excavatum Insurance Cover
The key to getting insurance cover for your pectus excavatum surgery if the insurance companies are being withholding is to be very persistent. There have been many cases I’ve heard of personally where people have scheduled a surgery and then hear the insurance company wont be covering the operation and having to cancel the surgery and get insurance cover back, this going on forth which can last a while and frankly drive you crazy when you know you or your child need the surgery.
The best way to handle this is to get the doctor and surgeon involved in the procedure of getting insurance some people even get the surgeons to call up the insurance company to give a formal description of your condition and why you need the surgery or get them to write a note to the insurance company. Most surgeons will write a note for you that you can fax over to your insurance company to support your claim but remember the most important thing to support your claim are the list of 4 things I mentioned above and these can be sent to your insurance agency.
Depending on your insurance cover , these sorts of operations will not be covered because they may see them as cosmetic but you can always try and push it to be more of a necessary surgery or at least get partial insurance cover on the surgery.
Find your Surgeon / Doctor
Also to note , If your looking for a Surgeon visit my Pectus Excavatum Doctor List, as I keep a quite a bit list of doctors around the world performing the surgery , that people have used and are happy with. YOu can reach it by clicking the Dr List at the very top of the page.
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Comments
How much does the nuss procedure cost usually?
I believe its around 10k because its such a specialized surgery, but most insurance companies will pay at least some of it if not all depending on your insurance cover and history.
David, we just visited a specialist for our son and the cost we were quoted was around $30 - $50,000. $10,000 is cheap. Does this include the 5 day hospital visit?
Hi , that sounds very expensive I think the 10,000 was just for the surgery not the hospital stay. But does your health insurance pay for any percentage of the costs? I was told that my health insurance would cover some of the costs which would make it cheap for me or was that 30k with health insurance paying some.
it also depends where you live too,
Hi, David! My 16 yo son was diagnosed about 2 yrs ago with Pectus Excavatum. The doctor we saw at the time did some research on it because she had never seen an actual case. We did not know he had it until he started going through puberty and started filling out. He has always been so skinny and it wasn't noticable, even to him. We were never told if his was mild, moderate or severe. We had pulmonary and cardiac studies done at the time and they just told us to repeat in 2-3 yrs. He has always had a little shortness of breath with exertion and he gets really tired. Our new doctor told me to research corrective surgery and if we decided to do it, he would refer us to a specialist, but we have to find one. My question is: Is it worth it medically to have it corrected? And what is the least invasive procedure available? Thank you and sorry so long!
well franklin regarding your question its really how much the PE is affecting your son's day to day life. A lot of people get the surgery for cosmetic reasons.
The least invasive procedure is the nuss surgery and probably the most popular for PE correction. that being said its not really uninvasive as you are stuck with a bar in your chest for quite a while.
I went to see a nuss surgeon a while ago and he said that unless its pushing on your heart and causing your internal organs harm its not always neccessary to have the surgery but people choose to due to the appearance. For me correcting my posture did a great deal to help me breath better , how is your sons posture.
check out pectuslist.com for a list of surgeons around the world and my other hubs I went through how the actual nuss procedure is performed.
goodluck if you have anymore questions let me know:)
should i go for it ? it looks painful. how long does it last from putting the bar in to the end of removing it ? and wat is the currency u guys are talking about ? i'm from singapore.
its up to you jonathon:) I think it was quite a while more than a year i think. check out http://hubpages.com/hub/Pectus-Excavatum-Surgery-P i think it may be on that page.
I was talking AUD but I think the other person may have been talking about USD, it really depends what sort of insurance cover you have to find out how much you will have to pay out of your pocket
Hi :)
I had reconstructive surgery performed when I was 2yo to correct my pectus. They took the bar out when I was 4yo.
Over the past couple of years my chest has fallen back in a good deal. The last week or so I've been having some scary problems breathing...
I just saw a local Thoracic surgeon and he said surgery wouldn't help me now. he said 10% chance it might even make it worse.
Well I CANNOT live like this. I got a referral for a 2nd opinion in Atlanta, GA (2hrs from my house in Augusta, GA).
I really hope I can find someone who knows what they are talking about.
Have you heard of this before? If your pectus falls back in years later after surgery, will the Nuss not help if performed again??
I had the surgery performed 18 years ago. I doubt they had the knowledge surgeons today have in this area dealing with pectus. There has to be someone who can help me...
Oh and we have military insurance that will cover a huge portion of the cost. The real problem is simply finding a surgeon who knows what he's talking about...
We got the cost of the surgery and the surgery (for me) will cost around $50,000 and we will have to pay around $5,000-6000.
hi CJ, I think its quite common for the surgery to wear off and your chest can return to how it was before the surgery the main reason is people neglect the maintenance exercises that should be done after the surgery.
You did have the surgery at a very young age so its possible your growth spurts just ruined the work from the surgery. Did the surgeon he give a reason why another surgery could make it worse?











David says:
4 months ago
How much does the nuss procedure cost usually?