Payment & Insurance Coverage for GAE

Health insurance can be a quagmire of paperwork. No matter what kind of insurance you currently have, it may not offer insurance coverage for GAE, genicular artery embolization. Always check with your doctor’s office about insurance before agreeing to have the procedure, or you may be stuck paying the entire amount. Astra Knee Pain Center provides a full range of documentation to your insurance provider to prove GAE is medically necessary. With this service, your odds increase that your insurance company will pay for it. Call Astra Knee Pain Center to reduce or eliminate your knee pain, while working toward your insurance carrier paying for GAE.

Do Insurance Companies Cover Genicular Artery Embolization?

Most insurance companies cover genicular artery embolization (GAE), but only if you’ve been diagnosed with knee osteoarthritis. This procedure is a relatively new treatment that hasn’t yet gained widespread acceptance, so contact your provider to determine your insurance coverage for GAE.

The Astra Knee Pain Center accepts most insurance plans and continuously expands its list of providers. Dr. George Bolotin — together with his team of knee pain specialists in Brooklyn and the Bronx — ensures that your treatments are insurance-approved or if not, that you’re aware of it before agreeing.

What’s Needed for Insurance Coverage for GAE Treatment?

Insurance companies are paying for GAE treatments only when they’re deemed medically necessary. You may need prior authorization, which the Astra Knee Pain Center can help. Your insurance company usually requires documentation demonstrating that GAE is medically necessary.

To get insurance coverage for GAE, you must:

• Provide strong documentation. Show that your chronic pain limits your movement and reduces your quality of life.
• Confirm medical need. Provide imaging tests that confirm the source of your knee pain.
• Conservative treatments. Include that conservative treatments failed to provide significant improvement.
• Use an in-network doctor. Make sure that your knee pain specialist in Brooklyn or the Bronx is in-network with your insurance plan, which reduces your out-of-pocket expenses.

Expect a final decision within 30 days. Your insurance company sends a written decision both to you and your doctor. In some cases, you get a decision in as little as 72 hours. You may get full coverage, partial coverage or no coverage. If your request is denied, you can appeal, supplying more complete documentation.

Common reasons for denial include:

• Lack of documentation
• Lack of proof that you tried conservative treatments before GAE
• Choosing an out-of-network knee pain specialist in Brooklyn or the Bronx

What Factors Influence My Cost When Paying for GAE?

Discuss with your knee pain doctor in Brooklyn or the Bronx to determine if genicular artery embolization is the right option for you. During this consultation, your doctor provides guidance about paying for GAE. When you plan to use insurance, the practice submits the needed documentation.

The costs to you when using your insurance coverage for GAE depends on various factors, including your:

• Deductible
• Copayment amount
• Coinsurance amounts, if applicable
• Insurance plan type

The cost of the GAE procedure without insurance ranges from $400 to $2,000. Get information from your knee pain doctor in Brooklyn or the Bronx when paying for GAE without insurance before you have the procedure.

If you have no health insurance or your claim is denied, your cost for the procedure depends on:

• The complexity of the procedurebecause treatment for multiple arteries cost more
• The type of materials usedto block the arteries
• The pre-procedure consultationwith your knee pain doctor in Brooklyn or in the Bronx
• The post-procedure care,determined by the knee pain specialists in the Bronx

Your well-being is the priority. If you have any questions about your GAE medical coverage, contact the Astra Knee Pain Center. These knee pain specialists in Brooklyn and in the Bronx ensure you maximize your medical insurance coverage for GAE when you need it.

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