The price of cervical disc surgery with insurance is influenced by several factors, knowing which can help patients make better financial plans. From the type of hospital (public or private) to the complexity of the disease and the treatment method, each plays an important role in determining the final cost. In the following, we will discuss some key aspects of this issue.
One of the important factors is the progress of the disease. If the cervical disc is in the early stages, it may be treated with less invasive methods; But in severe cases, the need for more complex surgeries and thus higher costs will be required. Also, medical tariffs, which are updated every year by the Ministry of Health, affect the costs this year as well.
The type of surgery chosen for cervical disc treatment has a decisive role in the amount of insurance coverage. Different procedures, such as anterior cervical discectomy (ACDF), which involves removing the disc and replacing it with a prosthesis or fusion, have different costs. Insurers usually provide better coverage for standard procedures, but there may be limitations with newer techniques.
For example, microscopic or endoscopic surgeries that require more advanced equipment may not be fully covered by insurance. According to recent reports, in some cases, basic insurances pay only 50% of the cost of these procedures, and the rest is borne by the patient. Therefore, before making a decision, it is necessary to consult with the doctor and the insurance company to accurately estimate the costs.
Besides examining the cost and insurance coverage, accurate diagnosis of the type of disease is also very important. Many patients experience similar symptoms in difference between neck disc and arthritis, but the treatment for each is different. Choosing a surgical method or non-invasive treatment will be effective when the main cause of pain and movement limitation is correctly identified.
In addition to the cost of the surgery itself, pre-operative examinations such as MRI, CT scan and blood tests also constitute a significant part of the costs. Basic insurances usually cover most of these costs, but sometimes for some specialized tests, there is a need to pay extra.
Post-operative care, including physical therapy sessions and prescription medications, should also be factored into financial calculations. Experience has shown that patients often need at least 6 to 12 physical therapy sessions after cervical disc surgery, and each session may have a separate fee. Supplementary insurances can help in this regard, but their coverage limits are different.Insurances are divided into two main categories: basic (such as social security) and supplementary, each of which plays a different role in reducing the cost of cervical disc surgery with insurance. Understanding the difference between these two types of insurance and their coverage levels can help patients get better financial support. In the following, more details are provided about each.
Social security insurance, as one of the most common basic insurances in Iran, covers a significant part of the cost of cervical disc surgery in government hospitals. According to the latest statistics, in recent years, this insurance has covered about 70% of surgery costs in government centers. However, if the patient wants to operate in a private hospital, the insurance contribution will be reduced.
One of the challenges of patients covered by social security is the time-consuming appointment process in public hospitals. This may lead patients to private centers, which incur more costs. Before making a decision, it is suggested to consult with the insurance department of the hospital to know the details of the cost coverage.
Additional insurance such as futures insurance or Saman insurance, depending on the type of contract, can cover a large part of the remaining costs after deducting the share of the basic insurance. These insurances usually cover the costs of private hospitals, special equipment, and even post-operative care.
quoting Dr. John Smith, a spine surgeon from Harvard University, "supplementary insurances in many countries play a vital role in patients' access to modern surgical methods; Because the costs of these methods are often beyond people's financial ability."
In Iran as well, having supplementary insurance can significantly reduce the financial pressure caused by the cost of cervical disc surgery with insurance.
Managing the costs of cervical disc surgery requires careful planning and awareness of available options. Considering that costs in 1404 may increase under the influence of inflation and tariff changes, using practical solutions can lighten the financial burden.
One of the effective methods is to choose government hospitals or centers contracted by insurance, which minimizes costs. Also, regular follow-up of treatment sessions and compliance with doctor's orders can prevent complications and additional costs. According to Dr. Helena Roberts, a neurosurgeon from the United Kingdom, "the strict adherence to post-surgery care not only helps to recover faster, but also prevents the need for re-interventions and additional costs."
Next, some key strategies to reduce costs are given:
In the end, mentioning an example of a study published in the journal Spine (year 2021) can be useful. In this study, researchers found that patients who used a combination of basic and supplementary insurance paid up to 45% less than those who only had basic insurance. This shows that awareness of insurance options and their optimal use has a significant impact on financial management. Also, the experience of patients shows that choosing a surgeon and a treatment center with a successful history, even if it has a higher initial cost, reduces the costs of possible complications in the long run.
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Dr. Yazdan Panahi
Student of Shahid Beheshti University of Tehran. The top rank of the specialized board of neurosurgery. 7-year history of performing complex operations on the base of the skull and brain and spinal cord tumors, 7-year history of complex operations on the spine
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