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A 42-year-old member asked:

My insurance refuse to pay anesthesia services during my breast surgery ? how is this possible?

5 doctor answers14 doctors weighed in
Dr. Luis Gonzalez
Obstetrics and Gynecology 39 years experience
$$$: Medical insurance is not about medical care anymore than banks are about education. The very fine print of your insurance contract spells out what they will pay for. You may have to pay for the anesthesia because of the nature of the procedure.
Dr. Karen Sibert
Anesthesiology 39 years experience
If the procedure was considered cosmetic, then it might not be covered.
Jul 7, 2012
Dr. Sean Canale
Breast Surgery 30 years experience
Out of network?: It is unlikely the anesthesia would not be covered as a service for an indicated surgery but it is possible the anesthesiologist may have been out of network or didn't accept your insurance.
Dr. Benjamin Nguyen
A Verified Doctoranswered
A US doctor answeredLearn more
Coverage varies: Anesthesia services can be billed together with the entire hospital bill, or can be billed separately: this depends on the billing structure of the particular hospital. If your insurance company does not contract with a particular anesthesiologist or anesthesia group, then you are responsible for the cost of service.
Dr. Richard Pollard
Anesthesiology 30 years experience
Call Them: This sounds like there might have been a coding error somewhere in the bill that was sent to the insurance company. No one would believe that you have to have a knee operation without anesthesia. I would call the facility where you had the procedure and ask them to help you with the insurance company. Good luck!
Dr. Tom Pousti
Specializes in Plastic Surgery
Depends on Situation: Much will depend on the type of breast surgery performed. If the operation was elective/aesthetic in nature, an insurance company will not pay for the services provided. If, on the other hand, the procedure was medically necessary, anesthesia services should be covered. Best to run your concerns by your surgeon's office for assistance.
Dr. Scott Welker
General Surgery 27 years experience
Most likely the anesthesiologist didn't accept your insurance. You just need to file for reimbursement.
Sep 13, 2013

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Last updated Jul 9, 2015

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