Microtia surgery costs vary greatly depending on the grade of the condition and the amount of reconstruction necessary. During you consultation with Dr. Jones, (see What Should I Expect During My Consultation with Dr. Jones?) he will evaluate your child’s condition and estimate the time and costs involved.

Microtia is a birth defect and ear reconstruction is generally considered corrective surgery of a missing body part, not cosmetic by insurance companies. Since there are a limited number of qualified surgeons to perform this surgery, most insurance companies and HMO’s recognize this fact and will approve Dr. Jones even if you are out of area.

Parents need to get pre-approval from their insurance carriers. This process can take several months and our office recommends that you start the process at least four to six months prior to ear reconstruction is scheduled to begin. Dr. Jones’ staff has extensive experience dealing with insurance carriers and will assist you if you are having difficulty. Different insurance companies and policies cover varying amounts and you need to directly consult with your insurance company to learn their policy.

In some cases, insurance providers will initially deny coverage as cosmetic or declare a surgeon to be “out-of-network”. You need to be proactive in dealing with your insurance company. If you are denied coverage, you are entitled to appeal. Be sure to document every phone conversation you have with your insurer with a confirming letter and send all correspondence to the insurer with delivery confirmation.

If you are discussing microtia surgery with your insurance company, be sure to always refer to the procedure as reconstructive, never cosmetic or plastic surgery.