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Coverage for Cortisone Treatments

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Medical

Cortisone injections can easily cost a lot out of pocket without the right coverage. The effectiveness of cortisone shots in dealing with inflammation, whether it be a cyst or inflammation of a joint, can be tremendously effective. Sometimes cortisone shots are often necessary to reduce pain associated with inflammation. The problem is that cortisone shots can cost anywhere from $25 to even $300, depending on the injection site, as well as the city and state where the injection is being delivered by a doctor. Should your doctor decide you would benefit from a cortisone shot, you’ll want to be covered by insurance in order to reduce these costs. If you may be in need of a cortisone injection, read on to learn more about cortisone insurance coverage.

Medicare

Original Medicare Parts A and B usually do not cover cortisone shots. However, they may be covered under Medicare Part D. Medicare Part D is the prescription drug plan added to Original Medicare. Part D did not exist until it was authorized in 2003 as part of Medicare. In January of 2006, Medicare Part D began covering individuals for prescription drugs. Generally, Medicare will not cover more than one shot per injection site, but if injected in separate joints then each joint will be covered.

Highlights:

  • Not covered by Part A and B
  • Covered under Part D
  • Only one shot per injection site

Medicare Advantage

Medicare Advantage plans are another way to get cortisone coverage. Medicare Advantage plans are offered through private insurance companies. With a Medicare Advantage plan you can get coverage where Medicare will not provide it. This includes covering your deductibles and copays. The Medicare Advantage plan will limit the amount you will pay for the cortisone injection and the doctor visit. With an Medicare advantage plan you could end up paying nothing out of pocket for your injection.

Highlights:

  • Will cover deductibles and copays
  • Will cover you when Medicare does not
  • Purchased in addition to Medicare

Private Insurance

While cortisone injections can easily cost some patients hundreds of dollars, this will not be the case with private insurance. Most insurance companies will cover cortisone shots if a doctor deems it necessary to relieve pain and inflammation. For an insured patient, the cost of a cortisone shot can range anywhere from $10 to $50. In order to be covered by insurance, the cortisone shot must be delivered by a doctor in a medical office. There may be additional charges if the doctor prescribes a special heat pack or ice pack but that cost should not exceed beyond $5.

Highlights:

  • Reduces cost as low as $10
  • Must be delivered in a medical setting
  • May be additional charges

Conclusion

Sometimes cortisone shots are the most effective way to deal with inflammation and pain associated with that inflammation. Although out of pocket the cost of the injection can be quite expensive, with comprehensive insurance costs, it may cost you little to nothing.