1. The post-operative spinal brace is approximately $700.00. If you don't have insurance, I can't answer the question because each person is different. In addition, most manufacturers prefer a scan to simple measurements because of the accuracy scanning provides by showing the actual physical anatomical shape.The following outlines the scanning options we can provide, with various price points, each with benefits over the other. Health care providers sometimes suggest kids wear a brace while they're growing. If your health care professional prescribed your back brace to be medically necessary, and you’re enrolled in Medicare Part B, your back brace should be covered by Medicare. Boston Orthotics & Prosthetics is a leader in scoliosis brace manufacturing, with options including the Boston Brace Original, the NEW Boston Brace 3D, Boston Brace Night Shift, Boston Brace RC, Boston Body Jacket, Boston Overlap Brace, and Boston Soft Spinal Orthosis. This is simply the range of possibility when it comes to price. This will include your room, the staff that is caring for you and food. For some, this may be many years and for others, a matter of months. But you need intermittent pressure on bones to stimulate growth, and the concavity needs to grow. Most insurance companies will cover the cost for the Boston Brace System. Q: How do I use a back brace for Scoliosis? It is not covered by the government’s Assistive Devices Program but most private insurance policies will cover … For example, Aetna considers surgery medically necessary only in severe cases where certain other criteria are met, and it considers some types of braces experimental. So is your budget. While it’s true that some braces cost thousands more than others, they don’t necessarily get better results. The cost of a spinal brace is similar to braces for the teeth. Between your surgeon’s billing office and the hospital billing staff, you should be able to understand all of the costs associated with your scoliosis correction surgery well ahead of your procedure date and prepare accordingly. These braces can only be used while bones are still growing. 4. How long is recovery? Boston O&P has the largest selection of "transfers" in the industry. If your child requires an orthotic device, a certified orthotist can help determine which device will fit your child's needs. Curves can get worse as kids grow and may cause health problems. Privacy Policy | Terms & Conditions. Don’t let insurance worries steer you away from getting the best treatment available. But that is where the similarity ends. Boston Orthotics & Prosthetics manufactures a lightweight foam and plastic helmet that treats a number of types of cranial asymmetry, including positional plagiocephaly, by providing a pathway for the infant’s head to grow into a more symmetrical shape. The team at Neurosurgeons of New Jersey remain committed and accessible to our patients. Many individuals that undergo a scoliosis correction surgery require physical therapy after their surgery. All require a prescription from a doctor stating that they recommend: “ daily use of the SpineCor ® brace for a minimum of 18 months. Another added expense in this same realm is allograft (donor bone) material for the “fusion” aspect of your surgery. 8. If appropriate, the orthotist submits an Application for Financial Assistance ("the application") to PharmaCare for pre-approval for the orthosis, on your child's behalf. There are braces that originated in Europe that cost thousands of dollars more than others. Every spine is unique. The insurer will want to know the severity of your scoliosis and if you have had, or are due, to have surgery. Dynamic Lycra® orthoses are a relatively new approach to managing abnormal tone and neurological dysfunction. The brace cost is covered by insurance. The aim is to improve functional abilities through the application of an orthosis designed to meet individual needs and objectives. Fabrication / Distribution and Customer Service: Find a Clinician/Certified Partner Near You. Medically required services you receive from physicians and midwives are medical benefits of MSP, as are diagnostic services including x-rays. The Charleston brace may be useful for children with scoliosis who are not compliant with a traditional Boston or Milwaukee TLSO brace or who do not respond well to TLSO braces (Roach, 2002). However, surgery is an established treatment for scoliosis, and, although it may require a lot of back-and-forth between you, your doctor, and the insurance company, ultimately your surgery should be approved if you are an appropriate candidate. On a forum at Scoliosis.org , patients discuss insurance coverage of braces. Boston O&P Clinic Appointments: Complete our Request An Appointment form Our Boston Brace 3D, which utilizes scanning technology, CAD/CAM modifications and has produced industry-leading results, is approved for the standard insurance coding system. It’s important to make sure you understand exactly what you’ll be requiring and how much it will cost. It was bulky and came with metal bars that resulted in neck immobilization. This typically lasts 4 – 10 days after your surgery. If you need help determining what your policy covers, just call us and provide your insurance information. Another serious issue with bracing is that bones cannot grow properly without intermittent pressure. While it’s not terribly common, your surgeon may recommend you use a brace following your surgery. We will contact you with those details. A few of our patients have brought to our attention that a major insurance carrier Aetna has denied reimbursement for the SpineCor brace. While this is a valid concern, the following information will help you better understand the cost associated with this procedure and how insurance works. Patient Billing Office: 888-964-3532 PharmaCare review… Once the swelling goes down, the spinal brace will be re-molded. Pre-surgical tests. As you can see, there is a lot that goes into a surgery — it isn’t just the procedure. Driving Directions ›, Fabrication / Distribution and Customer Service: 800.262.2235 Presently, there is not an insurance approved code specifically for these braces, therefore the claim could be totally denied or only partially reimbursed. The hospital or surgical facility where you’re having your scoliosis correction surgery can also help you navigate the portion of your surgery that will be paid for by your insurance provider. Braces are used to help provide support to your spine while it heals. 20 Ledin Drive Spine braces provide much more than cosmetic improvement, They may help stop progressive scoliosis, reduce pain, and improve quality of life over decades. Many clinicians are moving from simple measurements/casting to scanning. There are body molds in the marketplace that can get close to your specific body dimensions. If the condition cannot be effectively treated with less invasive treatment, your health insurance carrier should cover surgical intervention. Is scoliosis surgery covered by insurance? The theory behind bracing is that it will open the inside of the curve (the concavity) by removing pressure, and encourage growth on the concave side of the curve (the convexity). Boston Orthotics & Prosthetics is an expert in manufacturing and fitting lower extremity orthotics, including AFOs, KAFOs, SMOs, UCBs and hip abduction braces. Medicare Part B (medical insurance) may cover physician visits, physical therapy, and outpatient radiological services (including x-rays and magnetic resonance imaging or MRIs) for scoliosis treatment. Because each insurance carrier has different treatment protocols and schedules, be sure to ask any and all questions to your carrier and your medical team. In addition to the staff costs, the surgical procedure itself is typically billed separately. Boston Orthotics & Prosthetics is committed to providing excellent prosthetic care to both pediatric and adult populations. Some braces on the market today cost far more than what typical insurance pays. All Rights Reserved. Does anyone know why this type of surgery not covered by most health insurance policy's/physicians. Since Boston Orthotics & Prosthetics implemented CAD/CAM scanning and modification, many patients, families, and doctors alike, have asked what we are doing different that is making the braces fit so well. Many manufacturers are willing to work with individuals that don’t have insurance coverage for these types of devices. They are no more effective than the braces made by Boston Orthotics & Prosthetics, the makers of the original and most popular scoliosis brace, the Boston Brace. The brace question first: There are several kinds of braces. If it’s been recommended by your doctor, you’re probably starting to consider several important questions. If your surgery requires implants such as plates, screws, rods or other instrumentation, this will be added to the total. We take over 29 measurements in our custom braces to ensure performance and comfort. But for curves 25º and above, and ESPECIALLY for children and teens who are actively growing, treating scoliosis without a brace is dangerous and risky and is precisely why the well known BRAIST study 21 was ended prematurely: randomly assigning a child with scoliosis to a non-braced treatment group for research purposes isn’t ethical when the data shows that they have a significant … "Dr Gage is one of the best doctors I have ever met. Because scoliosis surgery is considered a major surgery, your spine surgeon will require a number of tests before you are “cleared” for the operation. They strive to maintain the quality and integrity of each device and provide the highest quality patient care and services. The PharmaCare Prosthetic and Orthotic program helps eligible patients, aged 18 or younger, with the cost of custom orthoses that help attain or maintain basic functionality or prevent further deformity. 10. Each insurance policy is different with regards to what they will cover for a particular patient having surgery with a particular surgeon and hospital. Its clinical policy bulletin states: The Copes Scoliosis Brace is a custom-fitted polypropene support structure that utilizes air to attain spinal curvature correction. Under its durable medical equipment benefit, Medicare Part B … Scoliosis correction surgery can be one of the best decisions you’ll ever make for yourself. The key word here is “close.” At Boston Orthotics & Prosthetics, every brace our orthotists fit meet the specific dimensions of the patient’s body. Physical therapy helps to strengthen muscles, increase flexibility, and teach proper posture. It just baffling to me that such an important surgery is not covered by most insurance policy's. You may be concerned that your scoliosis surgery won’t be covered by your insurance. Do insurance companies cover the Cheneau Rigo brace? The cost of such supports often range from $100 to $500 plus which for many, this can be a deal breaker. The brace when billed to your insurance can cost you zero dollars out of pocket because your deductible might have been met, or you may have to pay full price if your deductible has not been used all year. 6. The Providence Scoliosis System is similar to the Charleston brace but has the added advantage of derotation forces and likewise is designed to be worn only at night (d'Amato, et al., 2001). Unfortunately, CLEAR scoliosis treatment is not covered by ANY insurance, as Medicare has a strict policy on what they will and won't cover. 5. It’s always a good idea to check with your insurance provider to understand what will be covered and what won’t. Life Insurance when you have scoliosis can be available at standard terms. Your surgery will require not only the lead surgeon but also an anesthesiologist and team of other support staff. That way, there won’t be any surprises when you receive a bill for the portion your insurance may not cover. For patients covered by Medicare, back braces could be covered by insurance. Scoliosis makes a person's spine curve from side to side. If your child qualifies and is enrolled in Part B (Medical Insurance), Medicare can help cover the costs of doctor visits to diagnose the scoliosis, including X-rays, and a back brace if medically necessary. The ScoliBrace is a rigid brace, and therefore may be covered by your insurance plan. Boston Orthotics & Prosthetics has a selection of "transfers" that allow you to customize your orthosis to match your personality. The surgical team. There are many ways to treat and manage scoliosis including but not limited to braces, physical therapy, chiropractic treatment, osteopathic treatment, casting and as a last resort, surgery. Surgical supplies. 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