Orange County Orthopedics

Is Shoulder Impingement Surgery Covered by Insurance?

Shoulder impingement is a condition in which a tendon or bursa in the shoulder rubs against the shoulder blade, causing discomfort and limiting the shoulder’s range of motion. Sometimes, it is necessary to treat shoulder impingement with surgery. Because surgery is only used when medically necessary, you should be able to get shoulder impingement surgery covered by insurance.

About Shoulder Impingement Surgery

There are two main forms of shoulder impingement surgery. The majority of cases can be treated with minimally invasive arthroscopic surgery, if surgery is required at all. During arthroscopic surgery, the doctor makes tiny incisions near the shoulder and inserts small instruments and a camera called an arthroscope, allowing him to operate on the joint. Arthroscopic surgery can usually be performed on an outpatient basis, with no need for general anesthesia.

The other type of shoulder surgery is open shoulder surgery. During this type of surgery, the doctor makes a long incision near the shoulder and opens up the shoulder to directly visualize it. Open surgery is much more invasive, and usually requires a hospital stay, general anesthesia, and a longer recovery period.

Is Shoulder Impingement Surgery Covered by Insurance?

Your doctor will only recommend surgical treatment if no other treatments are likely to be effective for your condition. Therefore, you should be able to get shoulder impingement surgery covered by insurance.

Since your procedure will be covered by insurance, the terms of your insurance coverage will have the biggest impact on what you pay out of pocket. If you have already met your deductible, or have a low deductible, and also have a low copay, your out of pocket costs may be very small. If you have a large deductible or a higher copay, you may be responsible for covering a significant amount of the cost of surgery out of pocket.

Financing Options 

Many patients can cover their portion of the cost of shoulder surgery without much trouble, thanks to insurance coverage. However, if you are responsible for a large portion of the cost out of pocket, you may have difficulty paying the entire cost of surgery at once.

There are several financing options for spreading out the cost of surgery over a longer period of time. There are a number of patient financing companies that offer financing specifically aimed at helping patients cover medical procedures. Health care credit cards are another health care-specific option. You can also choose more general financing options, such as a loan, line of credit, or traditional credit card.

Dr. Howard Marans would be happy to meet with you about your shoulder health. To schedule your consultation today, please click below and enter your information or call OC Orthopedic at (714) 979-8981.

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