The Orthopedic Blog

Is ACL Surgery Expensive If I Have Insurance

Posted on Thu, Dec 26, 2013 @ 09:12 AM

Is ACL Surgery Expensive If I Have Insurance 

ACL surgery is necessary if an athlete has a severe tear to his ACL. The Anterior Cruciate Ligament (ACL) links the femur to the tibia and any injury to this ligament can result in a partial or a complete tear. It is exceedingly common among athletes who participate in contact sports, for instance rugby, lacrosse, and football, but even swimming and tennis can cause similar injuries. Women are more prone to incur this type of injury. While surgery is often the only option, there are certain important things to be considered, such as the medical costs, for example. ACL

Average Cost of Surgery

The average cost of surgery depends largely on whether or not the patient has insurance. If he has insurance, the standard cost of ACL surgery is approximately $1,900 (varying from $850 to $3,500). Patients should expect to pay out of their own pocket for other medical expenses, such as hospital admission and co-pay fees. Logically, the insurance carrier should cover the entire procedure. Nevertheless, if the patient does not have sufficient health insurance, the average cost is about $35,000 (varying from $25,000 to $55,000).

What Should the Expenses Include?

If an athlete suffers an ACL tear, the procedure to prepare for ACL surgery begins with rehabilitation, which prepares the injured knee for the surgical intervention. Keep in mind that rehabilitation is part of the after-surgery care, but it is often considered as an additional cost. During surgery, the orthopedic surgeon removes the damaged tendon and replaces it with either a tendon from a donor (mostly from a cadaver) or a tendon graft. Thereafter, the surgeon examines the joint to check for stability and flexibility in the new tendon.

Additional Expenses

A number of medical accessories that are often required to help the patient recuperate from the ACL injury will cost extra. Crutches and braces are normally covered by health insurance, but they can cost up to $500 if a patient is not covered. During recuperation, post-operative physical therapy fees can cost approximately $75 on an hourly basis. There is also an additional cost for prescription drugs in order to manage pain and swelling. If the initial reconstruction surgical procedure is rejected or damaged, the patient will have to undergo another surgery. Nevertheless, with health the proper insurance, it will be an affordable operation.

Conduct Research Online

People who need ACL surgery should conduct as much research as possible about the various medical costs associated with the operation. Find out from various orthopedic surgeons in the neighborhood and always ask about their accepted insurances.

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Topics: ACL surgery