Does Insurance Cover Cyst Removal?

The great debate in America is just what insurance will cover. The best medical insurance policies cover everything from major operations to the cotton swabs by your bed.

The worst medical insurance policies refuse to cover anything for inane reasons, like crying when you received bad news from your doctor.

With people always checking their policies and often having to argue with their insurance providers for things they certainly said they would cover before, many have turned to the internet in order to find out information that normally isn’t provided.

With this in mind, a common and often overlooked procedure has been under the microscope as of late: cyst removals.

But are cyst removals covered by insurance? Or are they swept under the rug like so many other procedures?

What is a Cyst?

A cyst is a closed and filled sac that forms on the skin, within a tissue, an organ, or even on the bone of a living being.

If we get down to the bare basics of it, cysts are an abnormal pocket that can be filled with skin cells, bacteria, or pus – through a collection of pus that has a blocked opening is normally an abscess, not a cyst.

Cysts are not to be confused with abscesses, which are pockets of infection and pus surrounded by inflamed tissue, which is painful, while cysts are collections of matter that are not painful.

The contents of a cyst can vary greatly but tend to contain air, fluid, or semi-solid matter, but not completely solid matter.

Cysts are normally non-cancerous growths that have a wall surrounding them with fluid inside, but there can be cancer related cysts as well, which form as a defense mechanism to deal with cancerous cells dividing rapidly.

These cells and the potential tumor they may have created are isolated and trapped within a wall that becomes a cyst and eventually a benign tumor.

If they manage to break free of this containment, the tumor will become cancerous and action needs to be taken.

Cysts can appear anywhere on the body, but most commonly occur on the face, scalp, neck, back, chest, and the soles of the feet and affect both men and women, and any age group, equally.

While they can be painful, they are not dangerous and most people can live with them without any problems.

What Causes Cysts?

Cysts are formed when dead skin cells, oils and bacteria build up around the root of a single hair that has become trapped inside the skin.

These cells grow and clump together into a sac that becomes filled with these trapped cells and a watery substance.

Most cysts are basically like an open blister and, if left for long enough, they will disappear, however your body may also get used to their presence, meaning that you forget or don’t notice them there.

Cysts are usually painless, but can be tender or itchy. Some cysts can be large, but most are small and go undetected. They can sometimes be seen as a small lump, pimple-like bump, or a blemish on the skin.

Will My Insurance Cover a Cyst Removal?

The answer is a solid maybe and most likely yes. Really, it depends on the insurance plan you are on, however you have a couple of good reasons to believe the insurance would cover it.

For starters, cyst removal will not cost them a huge amount like a major operation on your organs would. Secondly, if a cyst is being removed by a doctor, there is a damn good reason for it happening.

If a doctor decides to remove a cyst, it is because it could be cancerous, it is causing you pain or is debilitating to your life, or it has grown too large to ignore.

As such, it does not come under a cosmetic procedure, which makes it a medical procedure.

This makes it more likely to be covered by an insurance plan, and the costs will go against your deductible.

If your insurance covers it, and you’ve met your deductible, there is no reason an exact cyst removal shouldn’t be completely covered.

If you haven’t met your deductible, then you will probably have to pay out of your own pocket for the removal, but the removal will count towards the amount you owe.

However, you should always check your plan, just in case. You don’t want a surprise bill coming your way.

How Much is a Cyst Removal without Insurance?

The cost of cyst removal will vary from doctor to doctor and from patient to patient. Insurance policies can dictate how much you pay, or if you pay at all in some cases, but if you have no insurance then you will be footing the entire bill.

Luckily, cyst removal is not a very expensive procedure, but there are some doctors who will charge a lot of money for it, especially in certain private clinics in expensive areas.

These are often cosmetic surgeons who do cyst removals as a side business to cosmetic surgeries.

Most of the time though, cyst removal is often done in the office by a dermatologist, family doctor, or general surgeon, all of which offer far more reasonable prices.

Normally, a cyst removal will cost between $50 and $4000

The reason for the variation in price is what kind of procedure you get done to remove the cyst.

Most procedures are cheap because they will leave a small amount of scarring, as the doctor will have to cut the cyst and drain it, and the recovery time may be in the weeks.

The most advanced techniques, like a laparoscopy, take less recovery time and leave very little scarring, making them far more expensive.

Conclusion

Cyst removals are often covered by insurance policies because they are normally simple, safe, and cheap operations.

However, it is always best to check with your policy details before getting the operation, just in case your insurance provider decides to quibble its necessity.

Frequently Asked Questions