Hand Surgery Insurance & Cost in Portland, OR
Hand surgery procedures are often covered by insurance because they treat medical conditions that restore function and relieve pain. Unlike cosmetic procedures, hand surgery is classified as reconstructive and typically qualifies for insurance coverage. Dr. Sam Bartholomew, MD, FACS works with your insurance to maximize your benefits.
Is Hand Surgery Covered by Insurance?
Hand Surgery Is Usually Covered
Yes, most hand surgery procedures are covered by insurance because they:
- Treat medical conditions — not cosmetic concerns
- Restore function — restore grip, pinch, and mobility
- Relieve pain — eliminate chronic pain from conditions like ganglion cysts, trigger finger, and arthritis
- Improve quality of life — allow patients to work and perform daily activities
Insurance companies classify hand surgery as reconstructive surgery, which is typically covered.
Common Covered Hand Procedures
Ganglion Cyst Removal — Usually covered when the cyst causes pain or limits hand function
Trigger Finger Release — Typically covered because it treats a functional problem, not a cosmetic concern
Dupuytren's Contracture Treatment — Usually covered because it addresses a progressive condition affecting hand use
Thumb Arthroplasty — Generally covered when conservative treatment has failed and arthritis significantly limits function
De Quervain's Release — Typically covered because it relieves pain and restores wrist function
Insurance Coverage Process
Dr. Bartholomew's office handles the insurance verification and pre-authorization process for you:
- Insurance Verification — We verify your coverage and benefits
- Pre-Authorization — We submit pre-authorization requests to your insurance
- Cost Estimate — We provide your estimated out-of-pocket costs
- Claims Submission — We submit your claims to insurance
- Support — We handle insurance questions and appeals if needed
Understanding Your Insurance Coverage
Your out-of-pocket costs depend on several factors:
Deductible
Your annual deductible is the amount you must pay before insurance coverage begins. If you haven't met your deductible, you may be responsible for the full cost of surgery until your deductible is satisfied.
Co-insurance
After meeting your deductible, co-insurance is the percentage of costs you share with insurance (typically 10-20%).
Out-of-Pocket Maximum
Your out-of-pocket maximum is the total amount you'll pay in a calendar year before insurance covers 100% of costs.
Pre-Authorization Requirements
Most plans require pre-authorization before surgery. Dr. Bartholomew's office submits pre-authorization requests and handles the approval process.
Cost for Uninsured or Self-Pay Patients
If you don't have insurance or prefer to self-pay, Dr. Bartholomew's office provides:
- Transparent pricing — Clear breakdown of all costs
- Cost estimates — Exact estimates before surgery
- Flexible payment options — Payment plans to fit your budget
- Discount options — Potential savings for self-pay patients
Don't let cost concerns prevent you from treating painful hand conditions. Contact Dr. Bartholomew's office to discuss financing options.
Why Hand Surgery Makes Financial Sense
Hand surgery typically qualifies for insurance coverage, making it more affordable than cosmetic procedures. By treating your hand condition surgically, you:
- Restore your ability to work and earn income
- Eliminate chronic pain
- Improve quality of life
- Prevent further deterioration of hand function
- Avoid long-term disability
Most patients find that insurance coverage makes hand surgery an accessible investment in their health and quality of life.
Schedule Your Consultation
Ready to learn about coverage for your specific condition? Contact Dr. Bartholomew's office to schedule a consultation. We'll verify your insurance, discuss your coverage, and provide your exact cost estimate. Dr. Bartholomew will evaluate your condition and recommend the best treatment approach.
See Real Patient Results
From restoring hand function to relieving chronic pain, we've helped many patients overcome hand conditions. Explore our gallery.
Schedule Your Hand Surgery Consultation Today!
Ready to learn about insurance coverage for your hand condition? Contact Samuel V. Bartholomew, MD, FACS to schedule a consultation. We'll verify your coverage and provide your exact cost estimate.
Insurance & Financing Questions
Is ganglion cyst removal covered by insurance?
Yes, ganglion cyst removal is typically covered by insurance because the cyst causes pain or limits hand function. Insurance classifies this as reconstructive surgery, not cosmetic surgery. We can help verify your coverage.
Is trigger finger surgery covered?
Yes, trigger finger release is typically covered by insurance because it treats a medical condition that impairs hand function. Insurance companies classify this as reconstructive surgery.
What is the cost out-of-pocket?
Out-of-pocket costs depend on your insurance plan, deductible, and co-insurance percentage. For uninsured patients, Dr. Bartholomew's office provides cost estimates. Financing options are available.
What is the pre-authorization process?
Most insurance plans require pre-authorization before surgery. Dr. Bartholomew's office handles insurance verification and pre-authorization as part of the consultation process.
Do I need a referral?
Many insurance plans require a referral from your primary care physician before seeing a specialist. Our office can help guide you through the referral process.