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Strabismus surgery is a corrective procedure that differs from cosmetic surgeries, such as facelifts. The normal positioning of a person’s eyes is for both eyes to be looking in the same direction, at the same time. Since there is only one normal position that an eye may have, any deviation of the eye from that position is considered to be a medical disorder. As such, the diagnosis and treatment of strabismus should be covered by health insurance. Further, since Strabismus is a medical disorder that causes functional disability, Strabismus surgery should also be covered by health insurance as a corrective procedure.

Patients with medical insurance coverage will be required to pay surgery costs as specified by the insurance company for outpatient services and surgery. Diagnosis and treatment are likely to require co-pay as is required with other types of doctor office visits.

Patients are encouraged to check with their insurance carrier for the specifics of insurance coverage. If patients are denied coverage,it is likely to mean that the insurance company is not educated about the medical procedure Patients should request that their doctor make direct contact with the insurance company since the doctor is better able to communicate the medical procedure with the insurance company. Strabismus surgery was once considered to be a cosmetic procedure that was not covered by insurance. Today, almost all insurance companies provide some type of coverage for the surgery. Medicare provides coverage for Strabismus surgery as well as Botox® injections for the treatment of Strabismus.

Patients with no insurance coverage and the ability to pay may negotiate the surgeon’s fee with the prospective surgeon. However, these patients will also have to pay for the use of space, equipment, supplies and personnel at the medical institution where the procedure is performed. The cost of an anesthesiologist or other necessary specialist will also have to be paid.

Patients with no medical insurance coverage and without the ability to pay will have to seek the assistance of state or local medical assistance providers. They may also seek assistance from charities offered by many medical institutions, particularly large and established hospitals. These institutions may have charity programs established for low-income patients to pay a percentage of costs based on their income. Some charity programs will pay as much as 100% of certain hospital services. The onus falls upon the patient to ensure that the doctors and institute chosen to perform treatments and procedures accepts any acquired charity and or assistance.

About 700,000 eye muscle surgeries are performed annually in the United States.
The charges for Strabismus surgery can range anywhere from 2000 - 6000 USD or more, depending on the condition, surgeon's fees, general anaesthesia, other hospital charges, etc. The best way to find out the cost would be to consult a surgeon.

References:

  1. HealthAtoZ Article | Author: Lorraine Lica PhD .
  2. The Cost Ulititly of Strabismus Surgery in Adults Authors: Cynthia L. Beauchamp MD, George R. Beauchamp MD, David R. Stager Sr. MD, Melissa M. Brown MD, Gary C. Brown MD, Joost Felius PhD . American Association for Pediatric Ophthalmology and Strabismus.